ECCOMAS 2024

Computational modelling of biodegradable meshes for pelvic organ prolapse

  • Vaz, Francisca (LAETA, INEGI)
  • Silva, Elisabete (LAETA, INEGI)
  • Parente, Marco (LAETA, INEGI, FEUP)
  • Augusto, António (LAETA, INEGI, FEUP)

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Pelvic organ prolapse (POP) is a condition that affects the quality of life for many women and involves the descent of pelvic organs. The use of mesh treatment for transvaginal prolapse has been banned by the FDA due to high risks, which is why this study aimed to develop biodegradable meshes as an alternative to synthetic meshes for POP repair. Computational models were used to create meshes with variations in pore geometry, pore size, filament thickness, and the inclusion of filaments around specific mesh regions. One of the meshes was 3D printed to validate the simulation results, and a uniaxial tensile test was conducted on a sow's vaginal tissue to compare the results with the simulations to identify meshes that exhibited behaviour similar to that of vaginal tissue. Finally, the most promising outcomes were compared with those of the uterosacral ligament and a commercially available mesh. The mesh with a smaller pore diameter (1.50 mm), filaments in specific areas of the mesh, and variable filament thickness across the mesh most accurately replicated the behaviour of vaginal tissue based on a comprehensive analysis of the results. However, the meshes did not exhibit similar behaviour to the uterosacral when compared with the outcomes of the ligament. The commercially available mesh may also not be the best treatment option for POP repair, as it does not accurately represent the behaviour of both the vaginal tissue and the uterosacral ligament. The biodegradable meshes have biocompatibility and biomechanical properties that make them a potential solution to the drawbacks of synthetic meshes. Future research could focus on enhancing biodegradable mesh by incorporating different materials (PLA and PCL) with varying degradation periods, enabling customization based on individual patient needs and optimizing the repair process. Preliminary studies conducted with PLA and PCL filaments indicate a decrease in Young's modulus, from approximately 325 MPa to 120 MPa, compared to PCL filaments, which could lead to promising results in mesh development. Investigating the interplay between these materials and their impact on overall biomechanical performance may unveil innovative solutions for more effective and patient-specific POP repairs.