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INTRODUCTION AND HYPOTHESIS: Pelvic organ prolapse (POP) is a condition that affects millions of women worldwide with grave impact on their mental, social and sexual health. Previously, the polypropylene (PP) mesh was used to augment POP surgery. However, in 2019 the PP mesh was banned across multiple countries due to major complications and women were left with no alternative options. Complications arise, in part, secondary to the textile properties of the PP mesh. Development of a new pelvic implant to overcome previous complications will need to consider all these factors and optimise textile properties to enhance cell behaviour and tissue integration. METHODS: A critical literature review was conducted using PubMed/Medline, Embase, and the Cochrane Library (Wiley). Studies published in the last ten years analysing the textile properties of pelvic implants were included. Eligible papers investigated material composition, fibre type, pore size and porosity, and manufacturing techniques. RESULTS: PP meshes were associated with stiffness, deformation, and chronic inflammatory responses. Alternative materials such as polyurethane (PU), polyvinylidene fluoride (PVDF), polylactic acid (PLA) demonstrated enhanced elasticity, biocompatibility, and mechanical integrity. Electrospinning and wet spinning allowed finer control over fibre morphology and porosity. Optimal outcomes were observed with pore sizes 1 mm and porosity 50-70%, enabling vascularisation and immune cell infiltration without compromising the implant's strength. CONCLUSIONS: The textile design of pelvic implants critically determines surgical outcomes and biocompatibility. Future POP implants should utilise elastic, biocompatible materials with optimised pore architecture, fibre geometry, and controlled mechanical properties that replicate the native pelvic floor.
Seifalian et al. (Thu,) studied this question.