26 CAN NITRIC OXIDE IMPROVE TISSUE INTEGRATION OF POLYPROPYLENE MESH IMPLANTED IN SUBCUTANEOUS RATS?

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Basic Research I1 Apr 201226 CAN NITRIC OXIDE IMPROVE TISSUE INTEGRATION OF POLYPROPYLENE MESH IMPLANTED IN SUBCUTANEOUS RATS? Alessandro Prudente, Marcelo G. Oliveira, and Cássio L.Z. Riccetto Alessandro PrudenteAlessandro Prudente Campinas, Brazil More articles by this author , Marcelo G. OliveiraMarcelo G. Oliveira Campinas, Brazil More articles by this author , and Cássio L.Z. RiccettoCássio L.Z. Riccetto Campinas, Brazil More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.069AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Polypropylene (PP) sling has been considered the gold standard in surgical treatment of stress urinary incontinence. However, adverse events are still frequent, like mesh contraction, dyspareunia and vaginal mesh exposition, observed up to 11% of cases. Experimental studies have demonstrated that nitric oxide is effective to accelerate wound healing, increase angiogenesis and modulate collagen deposition. The aim of this study is evaluate inflammatory response and collagen deposition around the PP meshes coated with nitric oxide donor (S-nitrosoglutatione - GSNO) and poly (vinyl alcohol) (PVA) implanted in subcutaneous of rats. METHODS Thirty female rats have submitted to subcutaneous implant of five polypropylene mesh fragments following the protocol: uncoated mesh (control), mesh coated with PVA or mesh coated with PVA + GSNO in three concentrations: 1, 10 and 70 mMol. Animals were divided into 2 groups (15 each) and were euthanized at 4 days (group 1) and 30 days (group 2). Abdominal wall was excised en bloc for microscopic analyses. Five micrometers thick slices of the fixed abdominal wall, including the PP meshes, were prepared. The slides were stained with hematoxylin-eosin and analysed with 100x magnification. The tissue around the mesh was evaluated with Axio Vision software (Carl Zeiss -Germany). Frame percentage of the acute inflammatory reaction was quantified in group 1 and the thickness of fibrosis around the implant was measured in the group 2. ANOVA were used for comparisons. RESULTS At 4 days, all coated fragments presented more inflammatory reaction when compared to controls. Among the coated meshes, GSNO 1mMol showed the most inflammatory frame percentage (25,1% - p=0,0005). PVA, GSNO 10mMol and GSNO 70mMol exhibited similars responses (15,2%, 17,1% and 19,3%, respectively - p=0,91). At 30 days, fibrosis thickness was lower in GSNO 10 (mean:0,42±0,16 mm2 - p< 0,0001) and in GSNO 70mMol samples (mean:0,41±0,28 mm2 - p< 0,0001). These results suggest that GSNO 10 and 70 mMol are able to decrease fibroblastic response and PP fibrotic encapsulation, without increase the acute inflammatory reaction, since they presented similar frame percentage of inflammation at 4 days. CONCLUSIONS In proper concentrations, GSNO coating decreases fibroblastic reaction without change the acute inflammatory reaction of PP mesh implanted in subcutaneous of rats. Coating of PP meshes could represent an alternative to improve biocompatibility and prevent adverse events in pelvic floor reconstructive surgery. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e10 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alessandro Prudente Campinas, Brazil More articles by this author Marcelo G. Oliveira Campinas, Brazil More articles by this author Cássio L.Z. Riccetto Campinas, Brazil More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...