Morphogenetic Aspects of the Response of Vaginal Tissues to Polypropylene Implants as the Basis of Mesh-Associated Complications.

Morphometric and immunohistochemical examination of the vaginal mucosa before and 12 months after installation of polypropylene implants for the correction of stress urinary incontinence was performed in 20 patients with genital prolapse. The research results confirmed good biocompatibility of polypropylene and the formation of full-fledged connective tissue in the vaginal mucosa, but revealed the presence of a weak lymphocytic reaction to polypropylene 12 months after surgery. According to immunohistochemical study, increased contents of B lymphocytes and plasma cells responsible for the inductive and productive stages of the immune response were revealed in the vaginal mucosa around the implants 12 months after surgery. This reaction in the presences of provoking factors can lead to the development of inflammation and erosion, a type of mesh-associated complications.

Comparative Analysis of Connective Tissue Responses to Implantation of Biodegradable Material and Polypropylene in Experimental Animals.

We compared qualitative characteristics of the connective tissue at the site of implantation of polypropylene or a biodegradable polymer synthesized by electrospinning and consisting of 65% polycaprolactone and 35% polytrimethylene carbonate. Synthetic materials were implanted into the interfascial space of the muscles on the back of Wistar rats. The parameters of cellular and non-cellular structures of the forming connective tissue were studied in 1, 2, 3, 6, 9, and 12 months after implantation. It was found that the number of fibrocytes and fibroblasts around biopolymer and polypropylene increased during the period from 1 to 9 months, with a significant lag in case of biopolymer implantation; by 12 months, the number of fibrocytic cells did not significantly differ. The fibroplastic and angioplastic processes developed in the thickness of both materials, but with a one-month lag in case of biopolymer implantation due to degradation properties and nonporous structure of this polymer. Collagen fibers were actively synthesized around both materials, but in case of polypropylene, this process was more pronounced. In 6 months after implantation of polypropylene, dense regular connective tissue was formed; in 12 months after implantation of the biopolymer, the formation of dense irregular connective tissue was observed at the site of implantation. The biopolymer can be used to strengthen the core muscles.

Features of In Vitro Degradation and Physical Properties of a Biopolymer and In Vivo Tissue Reactions in Comparison with Polypropylene.

We compared in vitro degradation and physical properties of polypropylene and a biodegradable polymer synthesized by electrospinning and consisting of 65% polycaprolactone and 35% polytrimethylene carbonate as a possible alternative material for use in surgery for pelvic floor muscle failure. Samples of the studied polymers were implanted to 10 male Wistar rats into the interfascial space on the back (polypropylene on the right side and biodegradable polymer on the left side). The synthesized biopolymer was characterized by elongation and tear resistance, similar to those of polypropylene. During the period from the third to the sixth month after implantation, the area of fibrosis around individual polypropylene and biopolymer fibers increased by 16.7 and 107.9%, respectively, while remaining reduced compared to polypropylene. The total fibrosis area in 6 months after implantation of polypropylene and biopolymer samples significantly increased by 18% (p=0.0097) and 48% (p=0.05), respectively, i.e. fibrosing processes were more intense in case of biopolymer. Induction of more pronounced fibrosis can be an advantage of the synthesized biopolymer when choosing the material for fabrication of implants and their use for correction of incompetence of the ligamentous and muscular apparatus.

[Quality of life in women with small pelvic varicosity].

We surveyed a total of one hundred and ninety women presenting with small pelvic varicose veins (SPVIV). The chronic pelvic pain syndrome (CPPS) was revealed in nearly a quarter of the examined patients (24.7 %). The women's quality of life was assessed using the SF-36 questionnaire as a more integrative parameter, having demonstrated that women presenting with SPVV had a substantial decrease in all the components of both physical health and mental well-being. The obtained findings have strongly suggested the necessity of carrying out secondary prevention in women suffering from SPVV, even if there are no clinically pronounced manifestations of the disease.

[Criteria of diagnosis of small pelvis varicose veins in women at age-specific and biological periods of life].

Phlebography, ultrasonic, and Doppler examinations of pelvic venous system in women at age-specific and biological periods of life were used for diagnosis of varicose disease. Increase of the diameter of the main venous collectors and decrease of systolic velocity of venous blood flow into uterine veins are the main diagnostic criteria.

[Features of varicose veins of the pelvic region of women in premenopause and postmenopause].

The purpose of the research was definition of clinical current and diagnostic criteria of varicose veins of pelvis minor at woman of pre-menopause and post-menopause. The varicose veins of pelvis minor at woman of pre-menopause and post-menopause is characterized by decrease in a painful syndrome with heavy organic and functional defeat of veins system of a pelvis minor. The diagnostic criteria offered by the author will allow improving diagnostics of disease at women.

[Technique of definition and diagnostic criteria of a state of blood flow of pelvis minor in woman with pelvis minor varicosis].

The aim of the research: the examination of the state of woven blood flow in women with pelvis minor varicosis. The study of woven blood flow by the method of radioisotope clearance in 72 women of reproductive age is carry ouied. In patients with the varicose expansion of the veins of pelvis minor was revealed significant reduction in the indices of blood flow in the organs of pelvis minor, which plays the leading part in the genesis of painful sidroma.