Seifalian Amelia, Basma Zeinab, Digesu Alex, Khullar Vikram
Department of Urogynaecology, Imperial College, London W2 1NY, UK.
University College London (UCL) Medical School, London WC1E 6DE, UK.
Biomedicines. 2023 Mar 1;11(3):741. doi: 10.3390/biomedicines11030741.
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.
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.
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.
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.
聚丙烯（PP）盆腔网片是一种由PP聚合物制成的合成网片，用于治疗盆腔器官脱垂（POP）。由于有严重并发症的报道，其使用已引起高度争议。本研究批判性地回顾了POP的当前治疗选择以及PP网片作为治疗POP的一种可行临床应用。对PP材料的安全性和适用性进行了严格研究和批判性评估，同时考虑了PP的机械和化学性质。我们提出了具有新兴先进材料的“完美”合成盆腔网片的理想特性。
我们使用PubMed/Medline、Embase、Cochrane图书馆（Wiley）数据库和ClinicalTrials.gov数据库进行了文献综述，包括相关关键词：盆腔器官脱垂（POP）、聚丙烯网片、合成网片和网片并发症。
本综述结果发现，尽管PP无毒，但其物理性质表明其粘弹性与周围组织相比存在显著不匹配，这可能是并发症的一个原因。此外，在较长的随访期内PP网片与周围组织缺乏整合是不可逆并发症的另一个风险因素。
PP网片导致了涉及慢性疼痛和网片外露的并发症报告增加。这是由于PP网片的机械和物理化学性质。因此，多个国家已禁止使用PP网片治疗POP，目前尚无替代产品。我们建议开发一种使用包括新兴的基于石墨烯的纳米复合材料在内的先进材料的盆腔网片。
