Uniaxial biomechanical properties of seven different vaginally implanted meshes for pelvic organ prolapse

Abstract

Recently, numerous type I macroporous polypropylene vaginal meshes have been introduced into the market with little known of their differences. Seven vaginal meshes were obtained and loaded to failure (n = 5/type). Additional cyclic loading determined permanent deformation with submaximal loading. The load elongation curves demonstrated a bilinear response with lower stiffness (N/mm), followed by higher stiffness. Ascend™ was the stiffest mesh in both regions of the load elongation curve (0.72 and 1.66N/mm) with the lowest transition to higher stiffness (13.4%). Polyform™ had the highest failure load (53.8N) while Ultrapro™ had the lowest (7.83N). Novasilk™ (89.4%) and Ultrapro™ (87.9%) had the highest relative elongations at mesh failure while Ascend™ had the lowest (40.2%). Ascend™ had the least relative elongation after three protocols of cyclic loading (3.0%, 9.8%, and 9.7%). Current vaginal meshes demonstrate marked variation in biomechanical characteristics which may impact the in vivo behavior.