Department of Material Science & Engineering, Kroto Research Institute, University of Sheffield, UK.
Statement of the Problem: Pelvic organ prolapse (POP) and stress urinary incontinence (SUI) are two urogynecological diseases that affect 40-50% of postmenopausal women worldwide. Surgical interventions for these disorders require polypropylene (PPL) mesh placement to support the pelvic floor that can lead to severe complications in some patients. The need for synthetic materials more suited for use in pelvic floor repair is widely accepted. This study aims at developing an electrospun 17-β-estradiol releasing polyurethane scaffold that not only mimics the structural design of native human fascia but can also stimulate new extracellular matrix production and angiogenesis.
Methodology: Polyurethane (PU) scaffolds with and/or without 17-β-estradiol (25mg/g and 50mg/g) were prepared by blend electrospinning and mechanical properties of constructed scaffolds were assessed by uniaxial cyclic and non-cyclic testing. Water contact angle (WCA) measurements showed the hydrophilicity of the scaffolds. The viability and extracellular matrix production of cultured human adipose derived mesenchymal stem cells (hADMSCs) cultured on 17-β-estradiol releasing PU scaffolds was evaluated. The angiogenic potential of estradiol releasing scaffolds was evaluated using an ex ovo chick chorioallantoic membrane (CAM) assay.
Findings: The inclusion of 17-β-estradiol in PU scaffolds did not change the ultrastructure rather it significantly increased the UTS of scaffolds. Estradiol was released gradually from the scaffolds over a period of 3 months and hADMSCs on estradiol-releasing PU scaffolds showed more ECM production. The CAM assay showed a significantly higher angiogenic potential of estradiol-releasing PU scaffolds and histological examination showed appropriate cellular infiltration and improved tissue integration for all electrospun scaffolds compared to PPL.
Conclusion and Significance: We demonstrate the angiogenic potential of estradiol-releasing PU scaffolds with appropriate strength and elasticity desirable to support the pelvic floor.