Animal Experimental Research Assessing Urogynecologic Surgical Mesh Implants: Outcome Measures Describing the Host Response, a Systematic Review and Meta-analysis
| Autor: | Jacqueline Limpens, Aksel N Gudde, Carlijn R. Hooijmans, Zeliha Guler, Jan-Paul W. R. Roovers, Brita S. Kortz, Kim W J Verhorstert |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Urology
030232 urology & nephrology Host response Dentistry Review Article Cancer development and immune defence Radboud Institute for Health Sciences [Radboudumc 2] 03 medical and health sciences Gynecologic Surgical Procedures 0302 clinical medicine pelvic floor Outcome Assessment Health Care Animals Humans Medicine Review Articles 030219 obstetrics & reproductive medicine Pelvic floor foreign-body reaction business.industry Biomechanics Sham surgery Surgical Mesh pelvic organ prolapse in vivo Surgical mesh medicine.anatomical_structure Meta-analysis Vagina foreign‐body reaction Female Neurology (clinical) Animal studies Implant business biomaterials |
| Zdroj: | Neurourology and Urodynamics, 40, 5, pp. 1107-1119 Neurourology and Urodynamics, 40, 1107-1119 Neurourology and Urodynamics |
| ISSN: | 0733-2467 |
| DOI: | 10.1002/nau.24677 |
| Popis: | Contains fulltext : 234974.pdf (Publisher’s version ) (Open Access) AIM: Before the introduction of new biomaterials for prolapse surgery, animal studies on the host response are required. Unfortunately, large variation in study design hampers obtaining an overview of the safety and efficacy, and translation to clinical practice. Our aim is to systematically review the literature on all outcome measures describing the host response in animal studies assessing the biocompatibility of urogynecologic surgical mesh implants for prolapse surgery. Furthermore, by meta-analysis, we aim to assess the effect of implantation and compare this to control animals receiving sham surgery or native tissue repair. METHODS: We performed a systematic search from inception to August 2020. Since this is an explorative study we included original, controlled, and noncontrolled animal studies describing any host response to the implant. Quantitative outcome measures reported ≥10 times in ≥2 articles were eligible for meta-analysis. RESULTS: Fifty articles were included in the qualitative synthesis and 36 articles were eligible for meta-analysis. In total, 154 outcome measures were defined and classified into (1) histomorphology, (2) biomechanics and, (3) macroscopic morphology. Animals with vaginal implants demonstrated significantly increased M1 and M2 macrophages, MMP-2, neovascularization, TNF-α, and stiffness, and lower vaginal contractility compared to control animals. CONCLUSION: The host response significantly differs in animals after vaginal mesh implantation compared to control animals, both pro- and anti-inflammatory. However, we observed a paucity in the uniformity of reported outcomes. For future animal studies, we propose the development of a core outcome set, which ideally predicts the host response in women. |
| Databáze: | OpenAIRE |
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