Lin Meina, Lu Yongping, Chen Jing
NHC Key Laboratory of Reproductive Health and Medical Genetics (China Medical University) and Liaoning Key Laboratory of Reproductive Health, Liaoning Research Institute of Family Planning (The Affiliated Reproductive Hospital of China Medical University), Shenyang, China.
Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
Front Bioeng Biotechnol. 2022 Sep 6;10:968482. doi: 10.3389/fbioe.2022.968482. eCollection 2022.
Pelvic floor dysfunction (PFD) is a highly prevalent urogynecology disorder affecting many women worldwide, with symptoms including pelvic organ prolapse (POP), stress urinary incontinence (SUI), fecal incontinence, and overactive bladder syndrome (OAB). At present, the clinical treatments of PFD are still conservative and symptom-based, including non-surgical treatment and surgery. Surgical repair is an effective and durable treatment for PFD, and synthetic and biological materials can be used to enforce or reinforce the diseased tissue. However, synthetic materials such as polypropylene patches caused a series of complications such as mesh erosion, exposure, pain, and inflammation. The poor mechanical properties and high degradation speed of the biomaterial meshes resulted in poor anatomical reduction effect and limitation to clinical application. Therefore, the current treatment options are suboptimal. Recently, tissue-engineered repair material (TERM) has been applied to repair PFD and could markedly improve the prognosis of POP and SUI repair surgery in animal models. We review the directions and progression of TERM in POP and SUI repair. Adipose-derived stem cells (ADSCs) and endometrial mesenchymal stem cells (eMSCs) appear to be suitable cell types for scaffold seeding and clinical implantation. The multidisciplinary therapy approach to tissue engineering is a promising direction for tissue repair. More and longer follow-up studies are needed before determining cell types and materials for PFD repair.
盆底功能障碍(PFD)是一种在全球范围内影响众多女性的高度常见的泌尿妇科疾病,其症状包括盆腔器官脱垂(POP)、压力性尿失禁(SUI)、大便失禁和膀胱过度活动症(OAB)。目前,PFD的临床治疗仍然是保守的且基于症状,包括非手术治疗和手术。手术修复是治疗PFD的一种有效且持久的方法,合成材料和生物材料可用于加强或加固病变组织。然而,诸如聚丙烯补片之类的合成材料会引发一系列并发症,如补片侵蚀、暴露、疼痛和炎症。生物材料网片的机械性能差和降解速度快导致解剖复位效果不佳以及临床应用受限。因此,目前的治疗选择并不理想。最近,组织工程修复材料(TERM)已被应用于修复PFD,并能显著改善动物模型中POP和SUI修复手术的预后。我们综述了TERM在POP和SUI修复中的方向和进展。脂肪干细胞(ADSCs)和子宫内膜间充质干细胞(eMSCs)似乎是适合用于支架接种和临床植入的细胞类型。组织工程的多学科治疗方法是组织修复的一个有前景的方向。在确定用于PFD修复的细胞类型和材料之前,需要更多且更长时间的随访研究。