Homogeneous PHB–SF Electrospun Scaffolds as an Alternative to Synthetic Mesh for Stress Urinary Incontinence

Stress urinary incontinence (SUI) affects over 25% of adult women, with current surgical interventions primarily utilizing polypropylene mesh that can lead to complications including tissue erosion and chronic pain. This study investigates electrospun scaffolds combining polyhydroxybutyrate (PHB) and silk fibroin (SF) as a potential alternative to synthetic mesh. Scaffolds were fabricated with varying PHB/SF ratios (100/0, 75/25, 50/50, 25/75, 0/100) at both 3% w/v and 5% w/v concentrations. Mechanical and biological properties were characterized through scanning electron microscopy, dynamic mechanical analysis, differential scanning calorimetry, and energy‐dispersive spectroscopy. PHB‐dominant scaffolds demonstrated superior mechanical strength but limited cell attachment, while SF‐rich scaffolds had enhanced biological activity with improved fibroblast attachment and proliferation. In vitro studies using human vaginal fibroblasts showed increased cell proliferation and healthier morphology on SF‐dominant scaffolds, with all compositions reaching confluence by day 21. Similar to our in vitro findings, the 50/50 and 75/25 PHB/SF compositions achieved optimal balance between mechanical properties and biological response, suggesting potential as a biomaterial for SUI treatment. These findings establish PHB–SF scaffolds as a promising alternative to synthetic mesh, warranting their further investigation for clinical applications.