Hope on the horizon for women with urinary incontinence

Researchers have identified a promising alternative material for treating the condition of stress urinary incontinence.

A team of scientists and clinicians from the University of Sheffield (led by Professor Sheila MacNeil) and Sheffield teaching hospitals (led by Professor Christopher Chapple) have spent the last eight years trying to get a better understanding of why polypropylene (PP) mesh causes problems, how to assess these problems and how to develop a material that presents a safer alternative for patients.

In a key study published in the journal Biomaterials titled “A critical comparison of polypropylene and polyurethane sling materials after implantation in a suburethral sheep model,” the authors bring together their findings in which they present a more patient-friendly material made to mimic the patient’s own tissue and based on a distensible polyurethane (PU) approved by the FDA for a variety of other purposes.

For this study, they implanted the PU and PP material into a sheep model using exactly the surgical techniques that would be used in a human patient. After only three months, they were able to show deterioration in the PP material in the form of surface damage and the material becoming more rigid. In contrast, the PU material was undamaged and there was no increase in rigidity.

The past decade has seen an unacceptable percentage of women who have had polypropylene mesh implanted to help relieve the symptoms of urinary stress incontinence suffer from pain and inflammation, and even erosion of the mesh through the tissues. In response to this, regulators have banned the use of polypropylene (PP) mesh in several countries throughout the world, including the U.K.

Professor Sheila MacNeil said, “With this research, we really hope we can help restore patient trust. For too many years, patients have suffered as there have been no better or safer materials to use. This is particularly frustrating for surgeons who know that they are doing the right type of surgery that works for the majority of patients but not all. Surgeons need a more reliable material and patients need a safer alternative to the current polypropylene mesh.”

This innovative and comprehensive study points the way to developing and evaluating a safer material for surgeons to use to help women cope with urinary incontinence.