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. 2017 Jun 30;70(2):154-162.
doi: 10.5173/ceju.2017.1189. Epub 2017 Apr 14.

Structural differences and architectural features of two different polypropylene slings (TVT-O and I-STOP) have no impact on biocompatibility and tissue reactions

Mikolaj Przydacz  1 , Oussama El Yazami Adli  1 , Wally Mahfouz  1 , Oleg Loutochin  1 , Louis R Bégin  2 , Jacques Corcos  1
Affiliations

Structural differences and architectural features of two different polypropylene slings (TVT-O and I-STOP) have no impact on biocompatibility and tissue reactions

Mikolaj Przydacz et al. Cent European J Urol. .

Abstract

Introduction: To evaluate the impact of design features of the synthetic mid-urethral slings on tissue integrity and inflammatory responses.

Material and methods: In total 30 female Sprague-Dawley rats were implanted with type I monofilamentous, macroporous polypropylene meshes: Gynecare TVT-Obturator tape® (Ethicon Inc., Johnson & Johnson, Somerville, NJ, USA) and I-STOP® (CL Medical Inc., Lyon, France). All animal groups were sacrificed at set time intervals - 6 weeks, 3 months, 6 months, 9 months and 12 months - and the abdominal wall was harvested with mesh strips for histological evaluation.

Results: All mesh strips appeared to be well incorporated into the abdominal wall, and no signs of shrinkage was noticed. All specimens showed a thin/delicate, loose, fibrous interface between the synthetic graft plate and abdominal wall, along with mild inflammatory reactions from 6 weeks to 12 months.

Conclusions: Both mesh brands induced comparable, minimal foreign body reactions and integrated well into the host tissues despite differences in architectural features. TVT-O® and I-STOP® evoked similar low-grade inflammatory responses up to 12 months in this animal model. Structural differences and architectural features of polypropylene slings used in this study have had no impact on tissue integrity and inflammatory responses.

Keywords: I-STOP; TVT; histological assessment; inflammatory response; mid-urethral sling; tissue reaction.

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Conflict of interest statement

Drs. Przydacz, Adli, Mahfouz, Loutochin and Bégin have nothing to disclose. Dr. Corcos is a consultant for Astellas, Pfizer, Allergan, outside the submitted work.

Figures

Figure 1
Figure 1
Appearance of mesh strips before implantation: TVT-O® (right) and I-STOP® (left).
Figure 2
Figure 2
Appearance of mesh strips upon explantation at 12 months: TVT-O® (A) and I- STOP® (B).
Figure 3
Figure 3
Histological evaluation of I-STOP® mesh at 3 months. (A) Thin, uniform layer of fibrous tissue (arrows) interposed between the abdominal wall (left half) and apposed graft (right half). No associated intrinsically-active fibrosis or acute/chronic inflammation is apparent (H&E, 100x original magnification). (B) Mild foreign body reactions of mono- and multinucleated histiocytes surround the synthetic constituent without concomitant acute or chronic lymphoplasmacytic inflammation (arrows) (H&E, 200x original magnification).
Figure 4
Figure 4
Histological evaluation of TVT-O® mesh at 6 months. In addition to foreign body reactions (arrowheads) surrounding the synthetic constituent, which appears as empty lacunae, there is evidence of mild to moderately-active fibrosis, including a small number of admixed lymphocytes and plasma cells (arrows) (H&E, 200x magnification).
See this image and copyright information in PMC

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