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Sham\u2010operated animals (<jats:italic>n<\/jats:italic>\u00a0=\u00a012) served as controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>The mesh\u2013vagina complex was removed after 12\u00a0weeks and analysed for histomorphology, <jats:italic>in situ<\/jats:italic> cell apoptosis, total collagen, elastin, glycosaminoglycan content and total collagenase activity. Appropriate statistics and correlation analyses were performed accordingly.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Relative to sham and the two lower stiffness meshes, <jats:styled-content style=\"fixed-case\">G<\/jats:styled-content>ynemesh <jats:styled-content style=\"fixed-case\">PS<\/jats:styled-content> had the greatest negative impact on vaginal histomorphology and composition. Compared with sham, implantation with <jats:styled-content style=\"fixed-case\">G<\/jats:styled-content>ynemesh <jats:styled-content style=\"fixed-case\">PS<\/jats:styled-content> caused substantial thinning of the smooth muscle layer (1557\u00a0\u00b1\u00a0499\u00a0\u03bcm versus 866\u00a0\u00b1\u00a0210\u00a0\u03bcm, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.02), increased apoptosis particularly in the area of the mesh fibres (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.01), decreased collagen and elastin content (20%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.03 and 43%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.02, respectively) and increased total collagenase activity (135%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.01). Glycosaminoglycan, a marker of tissue injury, was highest with <jats:styled-content style=\"fixed-case\">G<\/jats:styled-content>ynemesh <jats:styled-content style=\"fixed-case\">PS<\/jats:styled-content> compared with sham and other meshes (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Mesh implantation with the stiffer mesh <jats:styled-content style=\"fixed-case\">G<\/jats:styled-content>ynemesh <jats:styled-content style=\"fixed-case\">PS<\/jats:styled-content> induced a maladaptive remodelling response consistent with vaginal degeneration.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.12085","type":"journal-article","created":{"date-parts":[[2012,12,14]],"date-time":"2012-12-14T17:43:16Z","timestamp":1355506996000},"page":"233-243","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":156,"title":["Vaginal degeneration following implantation of 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