Skip to main content
Log in

Tensile properties of commonly used prolapse meshes

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

To improve our understanding of the differences in commonly used synthetic prolapse meshes, we compared four newer generation meshes to Gynecare PS™ using a tensile testing protocol. We hypothesize that the newer meshes have inferior biomechanical properties.

Methods

Meshes were loaded to failure (n = 5 per group) generating load–elongation curves from which the stiffness, the load at failure, and the relative elongation were determined. Additional mesh samples (n = 3) underwent a cyclic loading protocol to measure permanent elongation in response to subfailure loading.

Results

With the exception of Popmesh, which displayed uniform stiffness, other meshes were characterized by a bilinear behavior. Newer meshes were 70–90% less stiff than Gynecare™ (p < 0.05) and more readily deformed in response to uniaxial and cyclical loading (p < 0.001).

Conclusion

Relative to Gynecare™, the newer generation of prolapse meshes were significantly less stiff, with irreversible deformation at significantly lower loads.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Pulliam SJ, Ferzandi TR, Hota LS, Elkadry EA et al (2007) Use of synthetic Mesh in pelvic reconstructive surgery: a survey of attitudes and practice pattern of urogynecologists. Int Urogynecol J 11:1–9

    Google Scholar 

  2. Nygaard IE, McCreery R, Brubaker L, Connolly A Cundiff G, Weber AM, Zyczynski H, Pelvic Floor Disorders Network (2004) Abdominal sacrocolpopexy: a comprehensive review. Obstet Gynecol 104:805–823

    PubMed  Google Scholar 

  3. Nicita G (1998) A new operation for genitourinary prolapse. J Urol 160:741–745

    Article  PubMed  CAS  Google Scholar 

  4. Floof CG, Drutz HP, Waja L (1998) Anterior colporrhaphy reinforced with Marlex. Mesh for treatment of cystocele. Int Urogynecol J Pelvic Floor Dysfunct 9:200–2004

    Article  Google Scholar 

  5. Jameson JS, Chia YW, Kamm MA et al (1994) Effects of age, sex, and parity on anorectal function. Br J Surg 81:1689–1692

    Article  PubMed  CAS  Google Scholar 

  6. Jones NHJ, Healy JC, King LJ (2003) Pelvic Connective Tissue resilience decreases with vaginal delivery, menopause and uterine prolapse. Br J Surg 90:466–472

    Article  Google Scholar 

  7. Olsen AL, Smith VJ, Bergstom JO et al (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506

    Article  PubMed  CAS  Google Scholar 

  8. Chen CG, Ridgeway B, Paraiso MF (2007) Biologic grafts and Synthetic meshes in pelvic reconstructive Surgery. Clin Obstet and Gynecol 50(2):383–411

    Article  Google Scholar 

  9. Dora C, Dimarco D, Zobitz M, Elliot D (2004) Time dependent variations in biomechanical properties of cadaveric fascia, porcine dermis, porcine small intestine submucosa, polypropylene mesh and autologous fascia in the rabbit model: implication for sling surgery. J Urol 171:1970–1973

    Article  PubMed  Google Scholar 

  10. Fenner DE (2000) New surgical mesh. Clin Obstet Gynecol 43:647–652

    Article  Google Scholar 

  11. Amrute K, Badlani G (2006) Female incontinence: a review of biomaterials and minimally invasive techniques. Current Opinion Urol 16:54–59

    Article  Google Scholar 

  12. Cosson M, Debodinance P, Boukerrou M, Chauvet MP, Lobry P, Crepin G, Ego A (2003) Mechanical properties of synthetic implants used in repair of prolapse and urinary incontinence in women: which is the ideal material. Int Urogynecol J 14:169–178

    Article  Google Scholar 

  13. Amid PK (1997) Classification of biomaterials and their related complications in abdominal wall surgery. Hernia 1:15–21

    Article  Google Scholar 

  14. Moalli PM, Papas N, Menefee S Abramowitch S (2008) Tensile properties of six commonly used mid-urethral slings. Int Urogynecol J 19:655–663

    Article  Google Scholar 

  15. Kohli N, Walsh PM, Roat TW, Karram MM (1998) Mesh erosion after abdominal sacrocolpopexy. Obstet Gynecol 92:999–1004

    Article  PubMed  CAS  Google Scholar 

  16. Mistrangelo E, Mancuso S, Nadalini C, Lijoi D, Costantini L (2007) Rising use of synthetic mesh in transvaginal pelvic reconstructive surgery: A review of risk of vaginal erosion. J Minim Invasive Gynecol 14:564–569

    Article  PubMed  Google Scholar 

  17. Huebner M, Fenner DE (2006) The use of graft material in vaginal pelvic floor surgery. Int J Obstet Gynecol 92:279–288

    Article  CAS  Google Scholar 

  18. Isom-Batz G, Zimmern PE (2007) Vaginal mesh for incontinence and/or prolapse: caution required!. Expert Rev Med Devices 4:675–679

    Article  PubMed  Google Scholar 

Download references

Conflicts of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Pamela A. Moalli.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jones, K.A., Feola, A., Meyn, L. et al. Tensile properties of commonly used prolapse meshes. Int Urogynecol J 20, 847–853 (2009). https://doi.org/10.1007/s00192-008-0781-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-008-0781-x

Keywords

Navigation