Histological properties in rats implanted with PP and PP/PLA.

<p>A. CD68 staining percentage after 15, 90 and 180 days. B. Collagen I staining percentage after 15, 90 and 180 days. C. Collagen III staining percentage after 15, 90 and 180 days. D. Collagen ratio (%) after 15, 90 and 180 days of implantation. Data are mean ± SD of n = 6 animals/ group *: p< 0.05.</p

Synthetic mesh repair of an anterior perineal hernia following robotic radical urethrocystectomy

<div><p>ABSTRACT Introduction: Perineal hernia is a protrusion of intra-abdominal viscera through a defect in the pelvic floor and is a rare but challenging complication after extensive abdominoperineal surgery. There have been small series published after colorectal exenteration, but no cases have been reported after radical cystectomy and urethrectomy. Case Presentation: A 68 years old woman developed an anterior perineal hernia, with no vaginal prolapse, after an anterior exenteration for bladder cancer. A perineal approach with the use of a synthetic polypropylene mesh was chosen to resolve the condition. After 6 months of follow-up, the patient has no symptoms or recurrence of the anterior perineal hernia. Conclusion: To our knowledge, this case is the first report of perineal hernia after radical urethrocystectomy. Although being a case report, this article describes a potential and challenging complication after extensive anterior pelvic surgery, that could increase its incidence in the future. Literature review shows that whether perineal, abdominal or combined approach is chosen, surgery must respect hernia repair principles.</p></div

Macrophage staining in explanted meshes.

<p>A PP mesh with CD68 staining after 15 days. B. PP/PLA mesh with CD68 staining after 15 days. C. PP mesh with CD68 staining after 180 days. D. PP/PLA mesh with CD68 staining after 15, 90 and 180 days. Scale bars are 100 µm.</p

Images of the abdominal hernia model.

<p>1A. Schematic showing the different layers of the abdominal wall and mesh placement. 1B. Photograph of implantation of the PP/PLA mesh. 1C. Schematic of full thickness defect and mesh placement.</p

A preclinical evaluation of polypropylene/polylacticacid hybrid meshes for fascial defect repair using a rat abdominal hernia model - Fig 2

<p>Images taken at euthanization (180 days) frontal view showing normal wound healing of PP mesh with skin (Fig 2A) and without skin (Fig 2B); frontal view showing mesh erosion in a PP mesh (Figs 2C and D). Fig 2 D (sagittal view) and F (frontal view) showing herniation of a PLA mesh.</p

Biomechanical properties in rats implanted with PP and PP/PLA.

<p>A. Breaking load after 15, 90 and 180 days. B. Stiffness after 15, 90 and 180 days. C Deformation after 15, 90 and 180 days of implantation. Data are mean ± SD of n = 6 animals/ group *: p< 0.05.</p

Nugent scoring system.

<p>Morphotypes are scored as the average number seen per oil immersion field (Note that less weight is given to curved Gram-variable rods). Total score = lactobacilli + <i>G</i>. <i>vaginalis</i> and Bacteroides + curved rods. 0 = No morphotypes present; 1 = <1 morphotype present; 2 = 1 to 4 morphotypes present; 3 = 5 to 30 morphotypes present; 4 = 30 or more morphotypes present.</p><p>Nugent scoring system.</p

Baseline data of non-analysed and analysed population within the study population (n = 728).

<p>BMI, Body Mass Index.</p><p>* mean ± standard deviation.</p><p>^$ n (%).</p><p>^¤ median [25^th percentile − 75^th percentile]</p><p>Baseline data of non-analysed and analysed population within the study population (n = 728).</p

Demographic and obstetric parameters of the analysed study population comparing women with and without 1^st to 4^th degree perineal tears.

<p>* mean ± standard deviation.</p><p>^$ n (%).</p><p>^¤ median [25th percentile − 75th percentile]</p><p>Demographic and obstetric parameters of the analysed study population comparing women with and without 1^st to 4^th degree perineal tears.</p

Flowchart describing the study population.

<p>Flowchart describing the study population.</p