Graft‐related complications and biaxial tensiometry following experimental vaginal implantation of flat mesh of variable dimensions
Abstract
Objective: To compare the occurrence of graft‐related complications (GRC s) and biomechanical properties of meshes implanted vaginally and abdominally. Design: In vivo animal experiment. Setting: Centre for S urgical T echnologies, M edical F aculty, KU Leuven, B elgium. Population: Twenty adult parous T exel ewes. Methods: Sheep were implanted with G ynemesh M, a 28‐g/m² polypropylene mesh reinforced with polyglecaprone fibres, under general anaesthesia. Dissection into the rectovaginal septum was performed to accommodate a flat 50 × 50 mm (n = 10) or 35 × 35 mm (n = 10) mesh, which was sutured to the underlying tissues. A 50 × 50 mm mesh was laid over a primarily sutured, full‐thickness, 40‐mm longitudinal abdominal wall incision. Sacrifice was at 60 days (n = 10) or 90 days (n = 5). Main outcome measures: The occurrence of exposure, the degree of contraction and examination of the biomechanical properties of explants with a minimum radius of 32 mm via biaxial tensiometry. Results: Insertion of a 50 × 50 mm mesh led to exposures in 30% (3/10) of cases, and the average contraction rate was 52 ± 14%. In the 35 × 35 mm implants, there were no exposures, and the contraction rate was 25 ± 26.3%. Vaginal explants with no GRC s and of sufficient size had biomechanical properties that were comparable with those of abdominal explants. Conclusion: Vaginal mesh insertion is associated with GRC s, such as exposure and contraction. Although other factors probably play a role, this study illustrates that mesh size may also induce these complications. In a vaginal surgery model, clinically occurring GRC s can be reproduced. In addition, biomechanics of uncomplicated vaginal explants are comparable with those measured on abdominal explants.
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In a sheep model, polypropylene mesh measuring 50 × 50 mm implanted into the abdomen or vagina demonstrated contraction.
“In a novel sheep model, PP mesh measuring 50 × 50 mm implanted into the abdominal or vagina of sheep demonstrated contraction, and indeed when implanted into the vagina, exposure of the mesh occurring in 3 out of 10 of the sheep by 90 days (Figure 3) [57].”
From How Can We Improve the Assessment and Indifferent Outcomes From Pelvic Organ Prolapse Management From Conservative and Surgical Therapies? ICI‐RS 2025 (2026) · cites this paper as [57]
In a sheep model, vaginal implantation of polypropylene mesh led to mesh exposure in 3 out of 10 sheep by 90 days.
“In a novel sheep model, PP mesh measuring 50 × 50 mm implanted into the abdominal or vagina of sheep demonstrated contraction, and indeed when implanted into the vagina, exposure of the mesh occurring in 3 out of 10 of the sheep by 90 days (Figure 3) [57].”
From How Can We Improve the Assessment and Indifferent Outcomes From Pelvic Organ Prolapse Management From Conservative and Surgical Therapies? ICI‐RS 2025 (2026) · cites this paper as [57]
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Kearney, R., Wagg, A., Bower, W., Chapple, C., Khullar, V., Robinson, D., Taithongchai, A., Hobson, P. T., Wein, A., & Abrams, P. (2026) · Neurourology and Urodynamics · doi:10.1002/nau.70272 · Cited by 1 · see citing works
“In a novel sheep model, PP mesh measuring 50 × 50 mm implanted into the abdominal or vagina of sheep demonstrated contraction, and indeed when implanted into the vagina, exposure of the mesh occurring in 3 out of 10 of the sheep by 90 days (Figure 3) [57].”
Synthetic and Biological Meshes for Pelvic Floor Disorders
Böhm, G. (2013) · Updates in surgery/Updates in surgery series · doi:10.1007/978-88-470-5441-7_27
Knight, K. M., Moalli, P., & Liang, R. (2018) · Springer eBooks · doi:10.1007/978-3-319-97073-8_8
The surgical management of uterine prolapse and the role of mesh
Izett-Kay, M. L. (2021) · UCL Discovery (University College London)
In Silico Evaluation of an Elastomeric Membrane for Prolapse Repairs
Lewis, S., Knight, K. M., Schneider, T., Ferguson, Z., Panozzo, D., Zorin, D., Moalli, P., & Abramowitch, S. D. (2026) · Urogynecology · doi:10.1097/spv.0000000000001840
- Authors
- Manodoro, S., Endo, M., Uvin, P., Albersen, M., Vláčil, J., Engels, A., Schmidt, B., De Ridder, D., Feola, A., & Deprest, J.
- Affiliations
- University of Milan (IT)
- KU Leuven (BE)
- Centre for Surgical Technologies, Faculty of Medicine KU Leuven Leuven Belgium
- European Competence Center of Healthcare Engineering Hemmingen Germany
- Department of Development and Regeneration, Faculty of Medicine KU Leuven Leuven Belgium
- Universitair Ziekenhuis Leuven (BE)
- Corresponding author
- Deprest, J
- Venue
- BJOG: An International Journal of Obstetrics & Gynaecology
- Publisher
- Wiley
- Published
- 2012-12-14
- Volume
- 120
- Issue
- 2
- Pages
- 244-250
- ISSN
- 0306-5456 (ISSN-L)
- 1470-0328
- 1471-0528
- OpenAlex
- W2051079669
- Cited by
- 65
- References
- 25
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 3 · 2021: 9 · 2020: 4 · 2019: 9 · 2018: 6 · 2017: 6 · 2016: 6 · 2015: 7 · 2014: 6 · 2013: 2 · 2012: 1
- FWCI
- 5.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
- PubMed (publishedVersion)
- Lirias (submittedVersion)
- Funders
- European Commission (251356)
- Fonds Wetenschappelijk Onderzoek Vlaanderen (1.8.012.07.N.02, 1803311N)
- Topics
- Health Sciences › Medicine › Surgery › Hernia repair and management
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Surgery › Surgical Sutures and Adhesives
- Keywords
- graft complications, mesh exposure, mesh contraction, mesh size, polypropylene mesh, rectovaginal septum, sheep model, pelvic organ prolapse surgery
- MeSH terms
- Abdomen, Animals, Biomechanical Phenomena, Female, Foreign-Body Migration, Prosthesis Failure, Sheep, Gynecologic Surgical Procedures, Surgical Mesh, Tensile Strength, Vagina, Models, Animal
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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