The Challenge of Stress Incontinence and Pelvic Organ Prolapse

Revisiting Biologic Mesh Materials

William D'Angelo; Jenna Dziki; Stephen F. Badylak


Curr Opin Urol. 2019;29(4):437-442. 

In This Article


There is clear clinical need for improved strategies for pelvic floor reconstruction. Biologic mesh materials are generally associated with better tissue integration and a departure from the classical pro-inflammatory host response and foreign body reactions associated with synthetic polypropylene mesh materials, but their degradation kinetics may not be sufficient for long-term strength of repair. Given the similarly high rates of reoperation following primary repair and mesh-augmented repair, as well the unacceptable incidence of mesh-related adverse effects, recent interest has focused on a number of material-based avenues to improve outcomes, including testing new materials, including biologic, synthetic, and composite materials, novel fabrication/manufacturing techniques, and surface modifications to increase strength and biocompatibility, as well as cell recruitment, attachment, and proliferation. A thorough understanding of mesh-related factors that contribute to postsurgical complications in pelvic floor reconstruction is an essential stepping-stone to improve patient outcomes.