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New Zealand white rabbit: a novel model for prolapse mesh implantation via a lumbar colpopexy

  • Katrina M. KnightEmail author
  • Amanda M. Artsen
  • Megan R. Routzong
  • Gabrielle E. King
  • Steven D. Abramowitch
  • Pamela A. Moalli
Original Article
  • 6 Downloads

Abstract

Introduction and hypothesis

New Zealand white rabbits are an inexpensive large-animal model. This study explored the rabbit as a model for mesh-augmented colpopexy using the intra-abdominal vagina. We hypothesized that polypropylene mesh would negatively impact rabbit vaginal smooth muscle (VSM) morphology and contractile function, similar to the nonhuman primate (NHP)—the established model for prolapse mesh evaluation.

Methods

Restorelle was implanted onto the vagina of ten rabbits via lumbar colpopexy after a hysterectomy. Ten rabbits served as sham. Twelve weeks post-implantation, the vagina was excised and VSM morphology and vaginal contractility were assessed. Outcome measures were compared using independent samples t and Mann-Whitney U tests with a Bonferroni correction, where appropriate. Results from the rabbits were compared with published NHP data.

Results

Animals had similar age, parity and BMI. VSM was 18% thinner after Restorelle implantation, P = 0.027. Vaginal contractility was 43% decreased in response to 120 mM KCl (P = 0.003), similar to the 46% reduction observed in the NHP vagina implanted with Restorelle (P = 0.027). Three meshes wrinkled in vivo, resulting in dramatic thinning of the underlying vagina in the area of the mesh causing a mesh exposure.

Conclusions

Polypropylene mesh negatively impacts VSM morphology and vaginal contractility in the rabbit, similar to the NHP, suggesting that the rabbit may serve as an alternative large-animal model. The vaginal thinning and appearance of a mesh exposure in the area of a mesh wrinkle suggest the rabbit may also serve as a model for understanding the pathophysiology of mesh exposure.

Keywords

New Zealand white rabbit Vaginal smooth muscle Pelvic organ prolapse Modified abdominal sacrocolpopexy Lumbar colpopexy Polypropylene mesh 

Notes

Acknowledgments

We are grateful for the financial support from the Department of Defense (DOD) (grant no. W81XWH-16-1-0133). The DOD did not provide any assistance with the study design, the collection, analysis and interpretation of data or in the writing of this report or in the decision to submit the article for publication. Research reported in this publication was also supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under award no. TL1TR001858. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors would like to thank Dr. Naoki Yoshimura MD, PhD (Professor of Urology, Pharmacology, and Cell Biology, University of Pittsburgh), for allowing us to use the organ bath system to collect the contractility data reported and Stacy Palcsey for her assistance with this study.

Funding

This study was funded by the Department of Defense (grant no. W81XWH-16-1-0133) and the National Center for Advancing Translational Sciences of the National Institutes of Health (award no. TL1TR001858).

Compliance with ethical standards

Conflicts of interest

None.

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Copyright information

© The International Urogynecological Association 2019

Authors and Affiliations

  1. 1.Department of MedicineUniversity of PittsburghPittsburghUSA
  2. 2.Magee-Womens Research InstitutePittsburghUSA
  3. 3.Magee-Womens Research Institute, Department of Obstetrics and Gynecology and Reproductive Sciences at Magee Womens HospitalUniversity of PittsburghPittsburghUSA
  4. 4.Department of BioengineeringUniversity of PittsburghPittsburghUSA

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