{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T08:35:05Z","timestamp":1770280505316,"version":"3.49.0"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T00:00:00Z","timestamp":1620172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["114024138"],"award-info":[{"award-number":["114024138"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Before the introduction of new biomaterials for prolapse surgery, animal studies on the host response are required. Unfortunately, large variation in study design hampers obtaining an overview of the safety and efficacy, and translation to clinical practice. Our aim is to systematically review the literature on all outcome measures describing the host response in animal studies assessing the biocompatibility of urogynecologic surgical mesh implants for prolapse surgery. Furthermore, by meta\u2010analysis, we aim to assess the effect of implantation and compare this to control animals receiving sham surgery or native tissue repair.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a systematic search from inception to August 2020. Since this is an explorative study we included original, controlled, and noncontrolled animal studies describing any host response to the implant. Quantitative outcome measures reported \u226510 times in \u22652 articles were eligible for meta\u2010analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty articles were included in the qualitative synthesis and 36 articles were eligible for meta\u2010analysis. In total, 154 outcome measures were defined and classified into (1) histomorphology, (2) biomechanics and, (3) macroscopic morphology. Animals with vaginal implants demonstrated significantly increased M1 and M2 macrophages, MMP\u20102, neovascularization, TNF\u2010\u03b1, and stiffness, and lower vaginal contractility compared to control animals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The host response significantly differs in animals after vaginal mesh implantation compared to control animals, both pro\u2010 and anti\u2010inflammatory. However, we observed a paucity in the uniformity of reported outcomes. For future animal studies, we propose the development of a core outcome set, which ideally predicts the host response in women.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.24677","type":"journal-article","created":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T08:16:31Z","timestamp":1620288991000},"page":"1107-1119","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Animal experimental research assessing urogynecologic surgical mesh implants: Outcome measures describing the host response, a systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9583-6657","authenticated-orcid":false,"given":"Kim W. J.","family":"Verhorstert","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Amsterdam Reproduction and Development, Amsterdam UMC University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aksel N.","family":"Gudde","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Amsterdam Reproduction and Development, Amsterdam UMC University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brita S.","family":"Kortz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Amsterdam Reproduction and Development, Amsterdam UMC University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacqueline","family":"Limpens","sequence":"additional","affiliation":[{"name":"Medical Library, Amsterdam UMC University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan\u2010Paul W. R.","family":"Roovers","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Amsterdam Reproduction and Development, Amsterdam UMC University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlijn R.","family":"Hooijmans","sequence":"additional","affiliation":[{"name":"Department for Health Evidence unit SYRCLE Radboud University Medical Center  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeliha","family":"Guler","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Amsterdam Reproduction and Development, Amsterdam UMC University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,5,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.300.11.1311"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(97)00058-6"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.01.051"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/968087"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-016-3029-1"},{"key":"e_1_2_9_7_1","volume-title":"Urogynecologic Surgical Mesh: Update on the Safety and Effectiveness of Transvaginal Placement for Pelvic Organ Prolapse","author":"FDA","year":"2011"},{"key":"e_1_2_9_8_1","volume-title":"Urogynecologic Surgical Mesh Implants","author":"FDA","year":"2019"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-012-1678-2"},{"key":"e_1_2_9_10_1","first-page":"1","volume-title":"Host Response to Biomaterials","author":"Badylak SF","year":"2015"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2535"},{"key":"e_1_2_9_12_1","unstructured":"Ouzzani HHM FedorowiczZ ElmagarmidA. 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