Bioerosion of Synthetic Sling Explants

This study was performed to investigate the changes over time in polypropylene (PP) mesh explants from women with stress urinary incontinence originally treated with a midurethral PP sling. Following Institutional Review Board (IRB) approval, 10 PP explants removed for pain or obstructive symptoms between January and June 2016 were analyzed through various techniques to determine the degradation of the material in vivo. Exclusion criteria were exposed or infected mesh sling or sling in place for less than six months. One pristine control was studied for comparison. The explant samples were analyzed with scanning electron microscopy to visualize the surface defects as well as infrared spectroscopy and energy dispersive X-ray spectroscopy to determine if the degradation was oxidative in nature. The results show qualitative and quantitative bioerosion over the surface of the explant samples and an increase in the content of oxygen pointing toward oxidative degradation occurring in vivo.