Table 2 The applications of biological materials for vaginal injuries

Xiao et al,

in 2023 [134]

Pig

4 cm thickness vaginal apical defects

DBM from pig bladder

4 cm;

Placed in the external cervical orifice and the vaginal stump

1.Integrated well with the vagina, achieve the regeneration of vaginal epithelial layers and muscularis.

2.Reconstruct the vaginal anatomy and restore the vaginal function.

Hympánová et al, in 2020 [135]

Sheep

3 cm longitudinal incision in the posterior vaginal wall

1.Ultra-lightweight PP non-degradable textile mesh

2.Electrospun implants (UPy-PC and PU mesh)

3.5 × 3.5 cm;

Placed in between vaginal epithelial layer and rectal serosa

1.These three meshes were well adapted for the vagina.

2.Electrospun implants had milder inflammatory response.

Ye et al, in 2020 [136]

Rat

Radiation-induced vaginal injury

3D protein scaffolds with ADSCs

Placed in the site of vaginal injury

A better therapeutic effect on the VS and contracture than simple ADSCs treatment.

Wang et al, in 2019 [93]

Rat

Bilateral oophorectomy

1.ADSCs of rat were treated with recombinant hCTGF

2.ADSCs-seeded APP and

ADSCs-seeded ABP

Placed in the vaginal mucosa, and the serosal surface was placed dorsally.

1.hCTGF promoted the expression of collagen I and III and induced ADSCs differentiation.

2. ADSCs -seeded APP and ABP reduced inflammation and improved the biocompatibility in vivo.

Zhang et al, in 2018 [54]

Rat

Vaginal mucosa was stripped

bone marrow MSCs-seeded SIS

Placed in the cervix and vaginal orifice (vaginal reconstruction)

1.The neovagina with SIS+MSCs had more smooth muscle, nerve tissue and angiogenesis than that with SIS only.

2.MSCs promoted neovagina recovery.

Chang et al, in 2017 [137]

Rat

An incision in posterior vaginal wall

Knitted silk fibroin scaffold

1 cm × 0.5 cm;

Placed in between vaginal fibromuscular layer and epithelial layer

Good biocompatibility;

No severe inflammation;

No mesh exposure complication.

Liang et al, in 2017 [138]

Rhesus macaque

Hysterectomy, uterosacral ligaments and paravaginal attachments transection

ECM bioscaffold from urinary bladder matrix

Placed in between

the level of uterosacral ligaments (level I support) and

paravaginal attachments (level II support), sutured to vagina.

1.Enhance the level I and level II support of vagina.

2.Impair vaginal integrity in a short time.

Zhang et al, in 2017 [139]

Rat

Hysterectomy and proximal vagina was removed by 1 cm

1.AVM from porcine vagina

2. SIS

from porcine intestine

Placed in between vaginal stump and retroperitoneal fascia

Compared with SIS, vaginal reconstruction with AVM were closer to normal vagina, and had nice biocompatibility and biomechanical properties.

Fan et al, in

2014 [140]

Rabbit

A 2 cm transverse incision in the posterior wall of vagina

1.PP mesh

2.Porcine-derived cUBM

2 cm × 1 cm;

Placed in between the fibromuscular layer and epithelium of vagina

1.Compared with cUBM, vaginal PP mesh had greater strength, and erosion.

2. Vaginal cUBM had milder inflammation response, better biocompatibility than PP mesh, and stable mechanical qualities.