Synthetic mesh for pelvic organ prolapse (POP) repair is associated with high complication rates. While current devices incorporate large pores (>1 mm), recent studies have shown that uniaxial loading of mesh reduces pore size, raising the risk for complications. However, it is difficult to translate uniaxial results to transvaginal meshes, as in vivo loading is multidirectional. Thus, the aim of this study was to (1) experimentally characterize deformation of pore diameters in a transvaginal mesh in response to clinically relevant multidirectional loading and (2) develop a computational model to simulate mesh behavior in response to in vivo loading conditions. Tension (2.5 N) was applied to each of mesh arm to simulate surgical implantation. Two loading conditions were assessed where the angle of the applied tension was altered and image analysis was used to quantify changes in pore dimensions. A computational model was developed and used to simulate pore behavior in response to these same loading conditions and the results were compared to experimental findings. For both conditions, between 26.4% and 56.6% of all pores were found to have diameters <1 mm. Significant reductions in pore diameter were noted in the inferior arms and between the two superior arms. The computational model identified the same regions, though the model generally underestimated pore deformation. This study demonstrates that multiaxial loading applied clinically has the potential to locally reduce porosity in transvaginal mesh, increasing the risk for complications. Computational simulations show potential of predicting this behavior for more complex loading conditions.
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February 2019
Research-Article
Deformation of Transvaginal Mesh in Response to Multiaxial Loading
William R. Barone,
William R. Barone
Musculoskeletal Research Center,
Department of Bioengineering,
University of Pittsburgh,
405 Center for Bioengineering,
300 Technology Drive,
Pittsburgh, PA 15219
e-mail: william.r.barone@gmail.com
Department of Bioengineering,
University of Pittsburgh,
405 Center for Bioengineering,
300 Technology Drive,
Pittsburgh, PA 15219
e-mail: william.r.barone@gmail.com
Search for other works by this author on:
Katrina M. Knight,
Katrina M. Knight
Musculoskeletal Research Center,
Department of Bioengineering,
University of Pittsburgh,
300 Technology Drive,
Pittsburgh, PA 15219
e-mail: kmk144@pitt.edu
Department of Bioengineering,
University of Pittsburgh,
405 Center for Bioengineering
,300 Technology Drive,
Pittsburgh, PA 15219
e-mail: kmk144@pitt.edu
Search for other works by this author on:
Pamela A. Moalli,
Pamela A. Moalli
Magee-Womens Research Institute,
204 Craft Avenue, Lab A320,
Pittsburgh, PA 15213
e-mail: moalpa@mail.magee.edu
204 Craft Avenue, Lab A320,
Pittsburgh, PA 15213
e-mail: moalpa@mail.magee.edu
Search for other works by this author on:
Steven D. Abramowitch
Steven D. Abramowitch
Musculoskeletal Research Center,
Department of Bioengineering,
University of Pittsburgh,
405 Center for Bioengineering,
300 Technology Drive,
Pittsburgh, PA 15219;
Magee-Womens Research Institute,
204 Craft Avenue, Lab A320,
Pittsburgh, PA 15213
e-mail: sdast9@pitt.edu
Department of Bioengineering,
University of Pittsburgh,
405 Center for Bioengineering,
300 Technology Drive,
Pittsburgh, PA 15219;
Magee-Womens Research Institute,
204 Craft Avenue, Lab A320,
Pittsburgh, PA 15213
e-mail: sdast9@pitt.edu
Search for other works by this author on:
William R. Barone
Musculoskeletal Research Center,
Department of Bioengineering,
University of Pittsburgh,
405 Center for Bioengineering,
300 Technology Drive,
Pittsburgh, PA 15219
e-mail: william.r.barone@gmail.com
Department of Bioengineering,
University of Pittsburgh,
405 Center for Bioengineering,
300 Technology Drive,
Pittsburgh, PA 15219
e-mail: william.r.barone@gmail.com
Katrina M. Knight
Musculoskeletal Research Center,
Department of Bioengineering,
University of Pittsburgh,
300 Technology Drive,
Pittsburgh, PA 15219
e-mail: kmk144@pitt.edu
Department of Bioengineering,
University of Pittsburgh,
405 Center for Bioengineering
,300 Technology Drive,
Pittsburgh, PA 15219
e-mail: kmk144@pitt.edu
Pamela A. Moalli
Magee-Womens Research Institute,
204 Craft Avenue, Lab A320,
Pittsburgh, PA 15213
e-mail: moalpa@mail.magee.edu
204 Craft Avenue, Lab A320,
Pittsburgh, PA 15213
e-mail: moalpa@mail.magee.edu
Steven D. Abramowitch
Musculoskeletal Research Center,
Department of Bioengineering,
University of Pittsburgh,
405 Center for Bioengineering,
300 Technology Drive,
Pittsburgh, PA 15219;
Magee-Womens Research Institute,
204 Craft Avenue, Lab A320,
Pittsburgh, PA 15213
e-mail: sdast9@pitt.edu
Department of Bioengineering,
University of Pittsburgh,
405 Center for Bioengineering,
300 Technology Drive,
Pittsburgh, PA 15219;
Magee-Womens Research Institute,
204 Craft Avenue, Lab A320,
Pittsburgh, PA 15213
e-mail: sdast9@pitt.edu
1Corresponding author.
Manuscript received November 5, 2017; final manuscript received August 14, 2018; published online November 29, 2018. Assoc. Editor: David Corr.
J Biomech Eng. Feb 2019, 141(2): 021001 (8 pages)
Published Online: November 29, 2018
Article history
Received:
November 5, 2017
Revised:
August 14, 2018
Citation
Barone, W. R., Knight, K. M., Moalli, P. A., and Abramowitch, S. D. (November 29, 2018). "Deformation of Transvaginal Mesh in Response to Multiaxial Loading." ASME. J Biomech Eng. February 2019; 141(2): 021001. https://doi.org/10.1115/1.4041743
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