Chapple Christopher R, MacNeil Sheila
The Royal Hallamshire Hospital.
The Kroto Research Institute, Materials Science and Engineering, North Campus, University of Sheffield, Broad Lane, Sheffield, UK.
Curr Opin Urol. 2019 Jul;29(4):431-436. doi: 10.1097/MOU.0000000000000619.
To review the current clinical management of stress urinary incontinence and pelvic organ prolapse following the adverse complications seen in the use of polypropylene mesh to treat both.
Materials developed for use in abdominal hernia repair have not proven risk-free when used to support pelvic organs particularly when inserted via the vagina. Following unacceptably high levels of severe complications when high-density polypropylene mesh is inserted via the vagina to treat pelvic organ prolapse, reported over the last decade, there is now an agreed consensus between surgeons about surgical approaches and materials, which should be recommended for use in stress urinary incontinence and pelvic organ prolapse.
There is a need for new biomaterials and tissue engineered/regenerative medicine approaches to treat stress urinary incontinence and pelvic organ prolapse. New materials need to be evaluated critically in both preclinical and clinical studies before being adopted into routine clinical use.
回顾在使用聚丙烯网片治疗压力性尿失禁和盆腔器官脱垂时出现不良并发症后的当前临床管理情况。
用于腹疝修补的材料在用于支撑盆腔器官时，尤其是经阴道插入时，并未被证明无风险。在过去十年报道了经阴道插入高密度聚丙烯网片治疗盆腔器官脱垂出现了不可接受的高严重并发症发生率后，目前外科医生对于应推荐用于压力性尿失禁和盆腔器官脱垂的手术方法和材料已达成共识。
需要新的生物材料以及组织工程/再生医学方法来治疗压力性尿失禁和盆腔器官脱垂。新材料在被纳入常规临床使用之前，需要在临床前和临床研究中进行严格评估。
