Journal article
Alterations of Vascular Endothelial Growth Factor A Expression and Microvessel Density Associated With Polypropylene Vaginal Mesh
Female pelvic medicine & reconstructive surgery, Vol.26(1), pp.73-79
01/2020
DOI: 10.1097/SPV.0000000000000593
PMID: 29683889
Abstract
Vaginal mesh exposure is the most common complication from mesh use in prolapse and incontinence surgery. Angiogenesis is an essential component of tissue healing, and defective angiogenesis plays a role in chronic wounds. We hypothesized that patients with exposures will have impaired angiogenesis as evidenced by altered tissue vascular endothelial growth factor A (VEGFA) expression and microvessel density. The study objective was to compare angiogenesis in women with vaginal mesh exposures, those with vaginal mesh without exposures, and in women who were mesh-naive. Patients undergoing polypropylene mesh removal and patients without mesh undergoing urinary incontinence or prolapse surgery were recruited. Full-thickness vaginal epithelial biopsies were obtained. The relative abundance of VEGFA RNA was measured with reverse transcription-polymerase chain reaction. The VEGFA and CD31 immunohistochemistry were also performed. Ninety-two subjects were enrolled and biopsied. Mean age (SD) was 57.2 (12.8) years, 16 (17.4%) were smokers, and 68 (73.9%) were postmenopausal.The VEGFA RNA expression did not differ between subjects with mesh exposure and with mesh but no exposure (P = 0.89). However, compared with subjects with no mesh, vaginal VEGFA expression was decreased in subjects with any implanted mesh (relative expression, 0.72; P = 0.02). Microvessel density was increased in subjects with mesh exposure compared with subjects with no mesh (P < 0.01). The VEGFA expression by immunohistochemistry was significantly lower in postmenopausal subjects without estrogen treatment compared with premenopausal and postmenopausal subjects being treated with estrogen (P = 0.02). The presence of polypropylene mesh and hormonal status are associated with evidence of altered angiogenesis.
Details
- Title: Subtitle
- Alterations of Vascular Endothelial Growth Factor A Expression and Microvessel Density Associated With Polypropylene Vaginal Mesh
- Creators
- Joseph T Kowalski - From the Division of Female Pelvic Medicine and Reconstructive SurgeryMichael J Goodheart - Division of Gynecologic Oncology, Department of Obstetrics and GynecologyRene Genadry - From the Division of Female Pelvic Medicine and Reconstructive SurgeryAva Bhattarai - Department of Pathology, University of Iowa Hospitals and ClinicsCatherine S Bradley - From the Division of Female Pelvic Medicine and Reconstructive Surgery
- Resource Type
- Journal article
- Publication Details
- Female pelvic medicine & reconstructive surgery, Vol.26(1), pp.73-79
- Publisher
- United States
- DOI
- 10.1097/SPV.0000000000000593
- PMID
- 29683889
- ISSN
- 2151-8378
- eISSN
- 2154-4212
- Language
- English
- Date published
- 01/2020
- Academic Unit
- Epidemiology; Obstetrics and Gynecology; Urology
- Record Identifier
- 9983931763202771
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