Effect of estrogen replacement on the histologic response to polypropylene mesh implanted in the rabbit vagina model

Objective

The aim of this study was to determine the effect of estrogen replacement after ovariectomy on the histologic response to polypropylene mesh implanted in rabbit vagina.

Study Design

Thirty rabbits were assigned to 5 groups: sham laparotomy, ovariectomy, ovariectomy-preoperative estrogen, ovariectomy-postoperative estrogen, or ovariectomy-preoperative and postoperative estrogen. Rabbits underwent sham surgery or ovariectomy and were infused with vehicle or 17β-estradiol (200 μg/d) for 4 weeks (“preoperative” estrogen). Polypropylene mesh was implanted in the posterior vaginal wall, and rabbits were infused with vehicle or “postoperative” estrogen for an additional 8 weeks. Grafts were harvested and underwent histologic evaluation.

Results

Vaginal atrophy in ovariectomized rabbits was reversed by estrogen replacement. Scores for inflammation (P = .33) and neovascularization (P = .23) at the graft site were not different among estrogen replacement groups, but estrogen administration was associated with increased collagen deposition (P = .005).

Conclusion

Estrogen replacement administered for 8 weeks postoperatively increases collagen deposition into polypropylene mesh.

Key words: estrogen replacement, pelvic organ prolapse, polypropylene mesh, rabbit model, synthetic graft