A biomechanical analysis of cervical fixation methods using shaped meshes for pelvic floor reconstruction in a porcine model.

Abstract

<h4>Purpose</h4>Pelvic organ prolapse (POP) in women is a common condition. Polypropylene meshes have an important place in the treatment. To date, a biomechanical comparison with a specific mesh design has not been performed for cervical fixation. The purpose of this study was to evaluate the biomechanical properties of different polypropylene mesh shapes and their fastening.<h4>Methods</h4>Biomechanical testing was performed with a porcine model using the Tension Testing machine Instron 5565®. The cervix was fixated in the Instron 5565® to measure its biomechanical properties. Measurement parameters comprised the maximum load (N), displacement at failure (mm), and stiffness (N/mm). In total, sixty trials were performed. These trials were subdivided into three groups. The first group used Y-shaped meshes fixated with 4 sutures (Y4). The second group used a Y-shaped mesh with 6 sutures (Y6). The third group comprised the standard cervical fixation (SF) utilizing a rectangular mesh with three sutures fixed horizontally on the anterior of the cervix.<h4>Results</h4>Y6 displayed the highest maximum load of 114 ± 19.4 N with displacement at failure 53.2 ± 12.3 mm. SF yielded the highest stiffness value 2.7 ± 0.74 N/mm with the second lowest maximum load and lowest displacement at failure. Y4 displayed the lowest maximum load 73,3 ± 20.5 N, second highest displacement at failure 40.5 ± 9.2 mm, and lowest stiffness 1.99 ± 0.85 N/mm.<h4>Conclusion</h4>Y6 displayed the overall highest results for maximum load and displacement at failure. The data derived from this study show that factors such as the shape of the mesh, number of sutures, and location of sutures play an important role in the uniaxial biomechanical properties.