Abstract

NEXT GENERATION TRANSVAGINAL MESH: BIOMIMETIC MATERIALS AND EVOLVING SURGICAL TECHNIQUES FOR PELVIC ORGAN PROLAPSE

M. Glory Esther Rani*, B. Triveni, D. Sai Priyanka, K. Arshiya Nousheen

ABSTRACT

Pelvic organ prolapse (POP) widely prevalent pelvic disorder affecting up to 65% of women over 40years of age, significantly affecting quality of life, sexual function, & urinary health. Native tissue repair was historically regarded as the primary surgical strategy, due to significant recurrence rates, transvaginal mesh was introduced to enhance anatomical durability & provide better apical support. Although structural outcomes improved, mounting reports of mesh-relatedcomplicationswere observed mesh-related complications including erosion, chronic pelvic pain, dyspareunia, infection & de novo urinary dysfunction. This led to major regulatory actions between 2008 & 2019, resulting in restrictions on transvaginal mesh use in many regions.As a result, focus shift toward biomaterial advancements & precision-driven surgical methods. Modern mesh technologies focus on enhanced biocompatibility, optimized pore structure, & Balanced mechanical properties. Recent developments involve refining (or) replacing conventional polypropylene constructs with advanced materials such as polyvinylidene fluoride (PVDF), tetanized polypropylene and biodegradable polymerslike (PCL) polycaprolactone. Novel bioengineering approaches, including auxetic geometries, 3D melt electro-writing fabrication, antibiotic-loaded scaffolds, and patient-specific implants are designed to mimic native tissue biomechanics while reducing inflammation and long-term complications. Current approaches in surgical management prioritize minimally invasive, function-preserving techniques, including robotic-assisted sacrocolpopexy, bilateral utero sacral ligament reconstruction, uterus-sparing hysteropexy and anchorless stabilization systems. Overall, these innovations are guiding a transition toward biomimetic, safety-centered/oriented, & individualized pelvic floor construction, redefining pop management through the integration of materials science, precise surgical techniques, and patient-reported outcomes.

Keywords: Pelvicorganprolapse; Transvaginalmesh; Biomaterials; Polyvinylidenefluoride(PVDF); Polypropylene mesh; Biodegradable scaffolds; Auxetic design; 3D melt electro writing; Sacrocolpopexy; Robotic-assisted surgery; Uterus-sparing procedures; Pelvic floor reco