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Cited by 51Pelvic floor disorders treatmentsHernia repair and managementSurgical Sutures and Adhesives

Polypropylene Pelvic Mesh: What Went Wrong and What Will Be of the Future?

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Seifalian, Amelia, Basma, Zeinab, Digesu, Alex, Khullar, Vikram·2023·Biomedicines
DOI 10.3390/biomedicines11030741PMC PMC10045074
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Abstract

Background: Polypropylene (PP) pelvic mesh is a synthetic mesh made of PP polymer used to treat pelvic organ prolapse (POP). Its use has become highly controversial due to reports of serious complications. This research critically reviews the current management options for POP and PP mesh as a viable clinical application for the treatment of POP. The safety and suitability of PP material were rigorously studied and critically evaluated, with consideration to the mechanical and chemical properties of PP. We proposed the ideal properties of the ‘perfect’ synthetic pelvic mesh with emerging advanced materials. Methods: We performed a literature review using PubMed/Medline, Embase, Cochrane Library (Wiley) databases, and ClinicalTrials.gov databases, including the relevant keywords: pelvic organ prolapse (POP), polypropylene mesh, synthetic mesh, and mesh complications. Results: The results of this review found that although PP is nontoxic, its physical properties demonstrate a significant mismatch between its viscoelastic properties compared to the surrounding tissue, which is a likely cause of complications. In addition, a lack of integration of PP mesh into surrounding tissue over longer periods of follow up is another risk factor for irreversible complications. Conclusions: PP mesh has caused a rise in reports of complications involving chronic pain and mesh exposure. This is due to the mechanical and physicochemical properties of PP mesh. As a result, PP mesh for the treatment of POP has been banned in multiple countries, currently with no alternative available. We propose the development of a pelvic mesh using advanced materials including emerging graphene-based nanocomposite materials.

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  • PP is widely used in tissue engineering, particularly in surgical meshes for hernia repair, pelvic organ prolapse, and other soft tissue reinforcement procedures.

    “Polypropylene (PP) is another widely used polymer in tissue engineering, particularly in the fabrication of surgical meshes for hernia repair, pelvic organ prolapse, and other soft tissue reinforcement procedures [242].”

    From Biomaterials in Postoperative Adhesion Barriers and Uterine Tissue Engineering (2025) · cites this paper as [242]

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Cited by

Sorted by citations

Authors
Seifalian, A., Basma, Z., Digesu, A., & Khullar, V.
Affiliations
  • Imperial College London (GB)
  • University College London (GB)
  • Department of Urogynaecology, Imperial College, London W2 1NY, UK
Corresponding author
  • Seifalian, Amelia
  • Khullar, Vikram
ORCID
Venue
Biomedicines
Publisher
MDPI AG
Published
2023-03-01
Volume
11
Issue
3
Pages
741
ISSN
2227-9059 (ISSN-L)
DOI
10.3390/biomedicines11030741
PMC
PMC10045074
OpenAlex
W4322740599
Cited by
51
References
2
Citations by year
2026: 8 · 2025: 25 · 2024: 13 · 2023: 5
FWCI
2.11
Type
journal article
Language
en
Open access
Licence
Locations
  • Biomedicines (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
  • Health Sciences › Medicine › Surgery › Hernia repair and management
  • Health Sciences › Medicine › Surgery › Surgical Sutures and Adhesives
Keywords
polypropylene mesh, pelvic organ prolapse, pelvic floor reconstruction, mesh complications, chronic pain, mesh exposure, tissue integration, graphene-based nanocomposites, advanced biomaterials

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