The Use of Biomaterials in Reconstructive Urology

Abstract

Objectives: Implant materials are used for a variety of reconstructive surgeries in urology including cystocoele, rectocoele, uterine prolapse, enterocoele and vault prolapse. We review the use of natural and synthetic implant materials in reconstructive urology and examine how these new biomaterials may behave in the management of those patients with surgical complications. We describe our experience with a new collagen biomaterial (Pelvicol™ Implant) in reconstructive urology and present a new technique for the surgical repair of cystocoele using a modified Raz surgical procedure for cystocoele grade III repair. Methods: Patients underwent either a Raz classical repair using polyglactin mesh ( n=30) or a modified Raz technique using Pelvicol™ Implant as a plug of overlay material ( n=28). Results: Preliminary results are presented with a mean follow-up of 9.3 months. There were no recurrences in the Pelvicol™ Implant group compared with three recurrences in the control group. Furthermore, there were no erosions or infections in the Pelvicol™ Implant group. The modified Raz technique prolonged the operation time by only 10 minutes. Conclusions: In vaginal reconstruction surgery, the ultimate goal is not only to mend damaged tissue, but also to replace or regenerate the tissue by sustaining it on some form of matrix. The second generation of biomaterials currently being evaluated provide great potential to achieve this objective.