Influence of different sling materials on connective tissue metabolism in stress urinary incontinent women

The aim of this study was to investigate the influence on the paraurethral connective tissue of different sling materials used in incontinence surgery . Biopsies from the paraurethral connective tissue were obtained intraopera tively from 16 women with stress urinary incontinence; all were operated on with the TVT procedure, 6 with Mersilene as the sling material and 10 with Prolene. Biopsies from 4 continent women with uterine bleeding irregularit ies, matched for age and parity, served as controls. New biopsies were obta ined from all women after 2 years. The biopsies were examined histologicall y and analyzed for collagen concentration and solubility. An obvious inflam matory reaction with a significant increase in collagen extractability by p epsin was identified in patients where Mersilene was used as the sling mate rial. A minimal inflammatory reaction without a significant change in colla gen solubility was found in the Prolene group. In the control group no infl ammatory reaction was seen. Mersilene gave rise to a significant foreign-bo dy reaction in the paraurethral connective tissue after surgery. Such a rea ction was not found with Prolene.