Electrospun poly-4-hydroxybuterate scaffolds enable local zero-order estradiol delivery and promote collagen maturation in a hypoestrogenic rat model for pelvic organ prolapse repair

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Pelvic organ prolapse (POP) affects millions of women globally, with postmenopausal hypoestrogenism playing a critical role in its development. Pelvic floor repair faces two major challenges: high recurrence rates and clinical complications that have been associated with permanent impants. Clinical complications may be reduced by using degradable implants. In fact, our previous research showed that absorbable poly-4-hydroxybutyrate (P4HB) implants result in fewer complications. We hypothesized that the high failure rates stem from impaired tissue regeneration and healing capacity, particularly in postmenopausal women requiring prolapse surgery who experience hypoestrogenism. Since estrogen is essential for tissue regeneration and pelvic floor integrity, we developed electrospun (ES) P4HB scaffolds with controlled estradiol (E2) release to enhance healing at the surgical site. In this study, we aimed to improve tissue regeneration through controlled release of estradiol (E2) at the surgical site. We investigated electrospun (ES) P4HB scaffolds loaded with E2 as a biodegradable alternative for POP repair. P4HB ES scaffolds with varying E2 concentrations (0%, 1%, 2%, and 5%) were fabricated and characterized for their physicochemical, mechanical, degradation, and drug eluting properties. Scaffolds had a suitable pore structure for tissue ingrowth and were strong and elastic enough

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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