TY - JOUR
T1 - Collagen Remodeling and Suburethral Inflammation Might Account for Preserved Anti-incontinence Effects of Cut Polypropylene Sling in Rat Model
AU - Chen, Chi Chiung Grace
AU - Hijaz, Adonis
AU - Drazba, Judith A.
AU - Damaser, Margot S.
AU - Daneshgari, Firouz
N1 - Funding Information:
This study was supported by grants NIH-NIDDK DK070004 and HD38679, the Clinical Investigator Award from the Cleveland Clinic, the Research Project Committee Award, and funding from the Department of Veterans Affairs, Rehabilitation Research and Development Service.
PY - 2009/2
Y1 - 2009/2
N2 - Objectives: To determine whether the inflammatory responses or collagen remodeling in suburethral tissue could have contributed to the preserved anti-incontinence effects of a cut polypropylene sling. Methods: Stress urinary incontinence was created in 60 age-matched female Sprague-Dawley rats that were subsequently randomized into 3 equal-size groups according to surgical procedure: placement of a vaginal suburethral sling, placement of a vaginal suburethral sling in which the suburethral portion of the sling was immediately cut, and sham surgery without placement of the sling. In a previous study, the leak point pressure measurements were obtained on these rats 6 weeks after surgery. The rats were then killed, the urethrovaginal tissue was harvested (cross-section of the entire urethra and anterior vagina) from 30 animals (10 from each experimental group), and the tissue was stained with hematoxylin-eosin and Masson's trichrome for histopathologic studies and picrosirius red for collagen fibers. Results: As previously published, the median leak point pressures were similarly and significantly increased in the rats in the intact and cut sling groups compared with those in the sham surgery group. The inflammatory mediators and interstitial edema were similarly increased in the intact and cut sling specimens compared with the sham surgery specimens. Under polarized light, picrosirius red-stained specimens from the sham surgery animals appeared to be composed of collagen that predominately birefringed red to yellow (typical of type I collagen). The picrosirius red-stained cut and intact sling specimens appeared to contain collagen fibers that predominately birefringed green (typical of type III collagen). Conclusions: Histologic changes, including inflammation, localized edema, and differential collagen remodeling, might contribute to the preserved anti-incontinence mechanisms of cut or intact polypropylene slings observed clinically.
AB - Objectives: To determine whether the inflammatory responses or collagen remodeling in suburethral tissue could have contributed to the preserved anti-incontinence effects of a cut polypropylene sling. Methods: Stress urinary incontinence was created in 60 age-matched female Sprague-Dawley rats that were subsequently randomized into 3 equal-size groups according to surgical procedure: placement of a vaginal suburethral sling, placement of a vaginal suburethral sling in which the suburethral portion of the sling was immediately cut, and sham surgery without placement of the sling. In a previous study, the leak point pressure measurements were obtained on these rats 6 weeks after surgery. The rats were then killed, the urethrovaginal tissue was harvested (cross-section of the entire urethra and anterior vagina) from 30 animals (10 from each experimental group), and the tissue was stained with hematoxylin-eosin and Masson's trichrome for histopathologic studies and picrosirius red for collagen fibers. Results: As previously published, the median leak point pressures were similarly and significantly increased in the rats in the intact and cut sling groups compared with those in the sham surgery group. The inflammatory mediators and interstitial edema were similarly increased in the intact and cut sling specimens compared with the sham surgery specimens. Under polarized light, picrosirius red-stained specimens from the sham surgery animals appeared to be composed of collagen that predominately birefringed red to yellow (typical of type I collagen). The picrosirius red-stained cut and intact sling specimens appeared to contain collagen fibers that predominately birefringed green (typical of type III collagen). Conclusions: Histologic changes, including inflammation, localized edema, and differential collagen remodeling, might contribute to the preserved anti-incontinence mechanisms of cut or intact polypropylene slings observed clinically.
UR - http://www.scopus.com/inward/record.url?scp=58649089624&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=58649089624&partnerID=8YFLogxK
U2 - 10.1016/j.urology.2008.07.033
DO - 10.1016/j.urology.2008.07.033
M3 - Article
C2 - 18829083
AN - SCOPUS:58649089624
VL - 73
SP - 415
EP - 420
JO - Urology
JF - Urology
SN - 0090-4295
IS - 2
ER -