OBJECTIVE: To evaluate and compare histological tissue reactions of the urinary bladder to human cadaveric fascia lata (CFX) slings and synthetic mesh.
METHODS: Thirty rabbits were randomized to three groups: group A (multifilament - Surgipro Mesh®) 12 animals, group B (CFX) 12 animals, and group C (surgical controls) 6 animals. A piece of Mesh or CFX was fixed in direct contact with the anterior bladder neck wall. The control group simply underwent sham bladder manipulation. The animals were sacrificed at 6- and 12-week intervals, and their bladders were collected for histological analysis.
RESULTS: Group A showed fibrosis within the detrusor of the bladder wall in half of specimens, including marked trans-mural inflammation in one case. The graft was incorporated within a plate of fibrous tissue with a foreign body-type granulomatous reaction to the synthetic material. In group B, no fibrosis or inflammation was seen within the bladder wall. The graft showed marked inflammation (mixed cell infiltrate) in all specimens, whereas foci of devitalized collagen with associated foreign body-type granulomatous changes and dystrophic calcification were present in more than half of specimens. No histopathological alteration was found in the control group.
CONCLUSION: Significant histopathological changes within the bladder wall occur in response to synthetic mesh as compared to CFX over two tested time intervals. We believe these differences are related to the lack of reported adverse outcome with the use of cadaveric fascia lata slings in regard to graft erosion or infection when compared to complications occurring with the use of artificial materials.