Evaluation Methods for Mechanical Biocompatibility of Innovative Prolapse Repair Meshes.

Abstract

Pelvic organ prolapse (POP) affects many women and involves the displacement of pelvic organs due to weakened support structures. While synthetic meshes are used in surgeries to reinforce these structures, they can lead to complications due to poor biocompatibility and mechanical properties. Biodegradable meshes offer an innovative solution, providing flexible and strong support that enhances tissue reinforcement and reduces the risk of injuries. The main objective of this study is to enhance our understanding and provide valuable insights into the performance of vaginal tissue and mesh implants, which may contribute to the advancement of POP treatment methodologies. This study utilized melt electrowriting to 3D print biodegradable mesh implants with quadratic and cross-shaped geometries, each with a thickness of 240 μm. Uniaxial and ball burst tests were performed on these meshes and sow's vaginal tissue to determine their mechanical properties, and a numerical simulation of the ball burst test was validated, allowing for accurate material representation. The results indicate that the placement of biodegradable PCL meshes in sow's vaginal tissue increases the maximum force by 14% to 20% during ball burst tests. Furthermore, the simulation effectively mimicked the experimental analysis, demonstrating a strong correlation with the experimental data for both the meshes and the tissue. The computational analysis for the quadratic-shaped mesh revealed a maximum difference of 7%, while the vaginal tissue simulation exhibited a difference of approximately 6%. However, discrepancies were observed in the tissue reinforced with the mesh, where the simulation yielded a maximum error of 14%, which may be attributed to the complex interactions between the mesh and the tissue. This multifaceted approach, integrating simulation, material testing, and experimental validation, forms the foundation of in-depth research into the mechanical behavior of vaginal tissue and mesh implants, making significant contributions to the field of POP treatment. Utilizing experimental analysis to validate numerical simulations is essential, as it allows for reducing the need for extensive randomized controlled trials (RCTs) and minimizing the use of animal testing once the simulations are validated.