Design and development of vaginal wall mimicking poly(ϵ-caprolactone) based nanofibrous prosthetic mesh for pelvic organ prolapse: evaluation of biocompatibility and antibacterial ability

Mechanical non-conformance of conventionally used transvaginal non-degradable meshes has led to complications such as organ perforation, dyspareunia caused by mesh stiffness and stress shielding. In this study, we have solved the dire need to mimic the mechanical properties of the vaginal wall by designing and developing a soft and elastic mesh made of polycaprolactone (PCL), citric acid modified polyethylene glycol (PEGC) and zinc oxide (ZnO) prepared through electrospinning and tested<i>in vitro</i>and<i>in vivo</i>. The mesh containing 90:10:0.1 of PCL, PEGC and ZnO (PEGC-15 0.1ZnO mesh) conforms to the mechanical properties of the vaginal wall of the pelvic floor, has a burst strength of ∼35 N even after gamma-sterilization and 28 d of degradation in<i>in vitro</i>.<i>In vitro</i>studies using adipose-derived stem cells revealed that the PCL-PEGC-15 0.1ZnO meshes were biocompatible and supported higher collagen production than commercial mesh.<i>An in vitro</i>bacterial adhesion study showed a 2-log reduction compared to commercially available mesh for prolapse treatment. Initial biocompatibility assessment in a rabbit model also showed that the PCL-PEGC-15 0.1ZnO mesh is biocompatible and supports fibrosis throughout the mesh. The softness and flexibility of the PCL-PEGC-15 0.1ZnO mesh based on<i>in vitro</i>trials and initial<i>in vivo</i>trials show that the mesh has a potential clinical impact for pelvic floor repair treatment.