Introduction: The sheep was evaluated as a potential model for preclinical evaluation of urethral slings in vivo based on: (1) anatomical measurements of the sheep vagina and (2) histological tissue integration and host response to polypropylene (PP) slings. Methods: Eight female, multiparous sheep were utilized. Three of 8 animals underwent surgery mimicking human tension-free vaginal tape protocols for midurethral slings and were euthanized at 6 months. The following measurements were obtained: vaginal length, maximum vaginal width with retraction, symphysis pubis length, and distance from the pubic bone to incision. Explanted sling samples from sheep and human were stained with hematoxylin and eosin for host reaction assessment. Results: Geometric measurements were similar between humans and sheep. Sheep vaginal anatomy allowed sling placement similar to procedures in human surgeries, and all sheep recovered without problems. Comparative histology between the sheep and human indicated similar host reaction and collagen deposition around implants, confirming suitability of the sheep model for biomaterial response assessment. Conclusion: Sheep vaginal length is comparable to humans. Tissue integration and host response to PP slings showed chronic inflammation with rich collagen deposition around the material in both sheep and human specimens, highlighting the sheep as a potential animal model for preclinical testing of midurethral slings.

1.
Isali
I
,
Mahran
A
,
Khalifa
AO
,
Sheyn
D
,
Neudecker
M
,
Qureshi
A
,
.
Gene expression in stress urinary incontinence: a systematic review
.
Int Urogynecol J
.
2020 Jan
;
31
(
1
):
1
14
.
2.
Rovner
ES
,
Wein
AJ
.
Treatment options for stress urinary incontinence
.
Rev Urol
.
2004
;
6 Suppl 3
(
Suppl 3
):
S29
47
.
3.
Moldovan
CP
,
Marinone
ME
,
Staack
A
.
Transvaginal retropubic sling systems: efficacy and patient acceptability
.
Int J Womens Health
.
2015
;
7
:
227
37
.
4.
Shah
HN
,
Badlani
GH
.
Mesh complications in female pelvic floor reconstructive surgery and their management: a systematic review
.
Indian J Urol
.
2012 Apr–Jun
;
28
(
2
):
129
53
.
5.
Colaco
M
,
Mettu
J
,
Badlani
G
.
The scientific basis for the use of biomaterials in stress urinary incontinence (SUI) and pelvic organ prolapse (POP)
.
BJU Int
.
2015 Jun
;
115
(
6
):
859
66
.
6.
Chapin
K
,
Khalifa
A
,
Mbimba
T
,
McClellan
P
,
Anderson
J
,
Novitsky
Y
,
.
In vivo biocompatibility and time-dependent changes in mechanical properties of woven collagen meshes: a comparison to xenograft and synthetic mid-urethral sling materials
.
J Biom Mater Res B Appl Biomater
.
2019 Apr
;
107
(
3
):
479
89
.
7.
Mangir
N
,
Hillary
CJ
,
Chapple
CR
,
MacNeil
S
.
Oestradiol-releasing biodegradable mesh stimulates collagen production and angiogenesis: an approach to improving biomaterial integration in pelvic floor repair
.
Eur Urol Focus
.
2019 Mar
;
5
(
2
):
280
89
.
8.
Song
R
,
Murphy
M
,
Li
C
,
Ting
K
,
Soo
C
,
Zheng
Z
.
Current development of biodegradable polymeric materials for biomedical applications
.
Drug Des Devel Ther
.
2018
;
12
:
3117
45
.
9.
Petros
PE
,
Ulmsten
UI
,
Papadimitriou
J
.
The autogenic ligament procedure: a technique for planned formation of an artificial neo-ligament
.
Acta Obstet Gynecol Scand Suppl
.
1990
;
153
:
43
51
.
10.
Petros
P
.
Creating a gold standard surgical device: scientific discoveries leading to TVT and beyond: Ulf Ulmsten memorial lecture 2014
.
Int Urogynecol J
.
2015 Apr
;
26
(
4
):
471
6
.
11.
Jiang
HH
,
Damaser
MS
.
Animal models of stress urinary incontinence
.
Handb Exp Pharmacol
.
2011
;
(202)
:
45
67
.
12.
Lorenzen
E
,
Follmann
F
,
Jungersen
G
,
Agerholm
JS
.
A review of the human vs. porcine female genital tract and associated immune system in the perspective of using minipigs as a model of human genital Chlamydia infection
.
Vet Res
.
2015
;
46
:
116
6
.
13.
Wijkstrom
M
,
Bottino
R
,
Cooper
DK
.
Limitations of the pig-to-non-human primate islet transplantation model
.
Xenotransplantation
.
2013 Jan-Feb
;
20
(
1
):
2
4
.
14.
Kerbage
Y
,
Giraudet
G
,
Rubod
C
,
Garabedian
C
,
Rivaux
G
,
Cosson
M
.
Feasibility and benefits of the ewe as a model for vaginal surgery training
.
Int Urogynecol J
.
2017 Oct
;
28
(
10
):
1573
7
.
15.
Lloyd
J
,
Crouch
NS
,
Minto
CL
,
Liao
LM
,
Creighton
SM
.
Female genital appearance: “normality” unfolds
.
BJOG
.
2005 May
;
112
(
5
):
643
6
.
16.
Becker
I
,
Woodley
SJ
,
Stringer
MD
.
The adult human pubic symphysis: a systematic review
.
J Anat
.
2010 Nov
;
217
(
5
):
475
87
.
17.
Mansoor
A
,
Curinier
S
,
Campagne-Loiseau
S
,
Platteeuw
L
,
Jacquetin
B
,
Rabischong
B
.
Development of an ovine model for training in vaginal surgery for pelvic organ prolapse
.
Int Urogynecol J
.
2017 Oct
;
28
(
10
):
1595
7
.
18.
Urbankova
I
,
Callewaert
G
,
Sindhwani
N
,
Turri
A
,
Hympanova
L
,
Feola
A
,
.
Transvaginal mesh insertion in the ovine model
.
J Vis Exp
.
2017 Jul 27
;
(125)
:
55706
.
19.
Hympánová
L
,
Rynkevic
R
,
Román
S
,
Mori da Cunha
MGMC
,
Mazza
E
,
Zündel
M
,
.
Assessment of electrospun and ultra-lightweight plypropylene meshes in the sheep model for vaginal surgery
.
Eur Urol Focus
.
2020 Jan 15
;
6
(
1
):
190
8
.
20.
Smith
TM
,
Smith
SC
,
Delancey
JO
,
Fenner
DE
,
Schimpf
MO
,
Roh
MH
,
.
Pathologic evaluation of explanted vaginal mesh: interdisciplinary experience from a referral center
.
Female Pelvic Med Reconstr Surg
.
2013 Jul-Aug
;
19
(
4
):
238
41
.
21.
Li
L
,
Wang
X
,
Park
JY
,
Chen
H
,
Wang
Y
,
Zheng
W
.
Pathological findings in explanted vaginal mesh
.
Hum Pathol
.
2017 Nov
;
69
:
46
54
.
22.
Turner
AS
.
Experiences with sheep as an animal model for shoulder surgery: strengths and shortcomings
.
J Shoulder Elbow Surg
.
2007 Sep-Oct
;
16
(
5 Suppl
):
S158
63
.
23.
Webster
J
.
Ethical and animal welfare considerations in relation to species selection for animal experimentation
.
Animals
.
2014
;
4
(
4
):
729
41
.
24.
Zacharopoulou
C
,
Nassif
J
,
Allemann
P
,
Dallemagne
B
,
Perretta
S
,
Marescaux
J
,
.
Exploration of the retroperitoneum using the transvaginal natural orifice transluminal endoscopic surgery technique
.
J Minim Invasive Gynecol
.
2009 Mar-Apr
;
16
(
2
):
198
203
.
25.
Herrera-Imbroda
B
,
Lara
MF
,
Izeta
A
,
Sievert
KD
,
Hart
ML
.
Stress urinary incontinence animal models as a tool to study cell-based regenerative therapies targeting the urethral sphincter
.
Adv Drug Deliv Rev
.
2015
;
82-83
:
106
16
.
26.
Vandamme
TF
.
Use of rodents as models of human diseases
.
J Pharm Bioallied Sci
.
2014 Jan-Mar
;
6
(
1
):
2
9
.
27.
Zacharin
RF
.
Genital prolapse in ruminants
.
Aust N Z J Obstet Gynaecol
.
1969 Nov
;
9
(
4
):
236
9
.
28.
Couri
BM
,
Lenis
AT
,
Borazjani
A
,
Paraiso
MF
,
Damaser
MS
.
Animal models of female pelvic organ prolapse: lessons learned
.
Expert Rev Obstet Gynecol
.
2012 May 1
;
7
(
3
):
249
60
.
29.
Low
JC
,
Sutherland
HK
.
A census of the prevalence of vaginal prolapse in sheep flocks in the borders region of Scotland
.
Vet Rec
.
1987 Jun 13
;
120
(
24
):
571
5
.
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