EXPERIMENTAL MORPHOLOGICAL RATIONALE FOR THE USE OF MULTIPOTENT MESENCHYMAL STEM CELLS CULTURES IN COMBINATION WITH BIOMATERIALS FOR THE RECONSTRUCTION OF THE PELVIC FLOOR

To date, descension of the pelvic floor is a fairly common gynecological pathology that requires surgical treatment. The development of cellular technologies suggests that the use of multipotent mesenchymal stem cells (MMSC) in the treatment of this pathology can stimulate the regeneration of damaged tissue and contribute to the reconstruction of the structures of the pelvic floor. Objective: to evaluate the effectiveness of using MMSC in combination with biological and synthetic materials in vitro and in vivo with descension of the pelvic floor. Materials and methods: Sprague Dawley rats 10 weeks old weighing 200 grams were used in the experiment. Under sterile conditions, mechanical damage to the posterior wall of the vagina was carried out, with the restoration of which vicryl 3-0 was used. On the 2nd and 4th day, the wound was cut off in a volume of 1.5 ml with xenograft, allograft and multipotent mesenchymal stem cells (MMSC) (5 thousand cells) obtained from the adipose tissue of rats. In the control group was not used biological material. At the second stage of the experiment, the compatibility of the mesh prosthesis with MMSC and allograft in vitro was evaluated. Results and discussion: xenograft does not lead to full tissue regeneration, but contributes to rapid epithelialization and reduces the degree of inflammatory reaction in the wound during the regeneration of connective tissue. The use of allograft leads to quick and complete epithelialization of the wound and the formation of a structurally complete connective tissue lamina of the vaginal mucosa. The introduction of MMSC resulted in complete epithelialization of the wound and the formation of a structurally complete connective tissue plate of the mucosa and submucosa, but with a slightly smaller number of blood vessels in them than with the use of a biomaterial. At the second stage of the experiment, weak cell adhesion to the polypropylene substrate of the tablet was observed during cell culture in the presence of only a fragment of the mesh prosthesis. After MMSC cultivation in the presence of a mesh prosthesis fragment and an allograft, a relatively uniform distribution of cells around the mesh prosthesis loops was observed. Conclusions: it was determined that the use of MMSC and allograft has a positive effect on the process of vaginal tissue regeneration in rats. When combining these materials with mesh prostheses, it was found that MMSCs are not fixed directly to the synthetic material, but when the allograft is added, they concentrate and presumably have the maximum anti-inflammatory effect and promote tissue regeneration at the site of the mesh prosthesis. Thus, the use of autologous MMSC cells in combination with allograft and mesh polymeric materials for pelvic floor reconstruction can significantly improve the results of reconstructive operations.

stem cells, allograft, xenograft, pelvic floor descension, pelvic floor reconstruction