Abstract
Background:
Pelvics organ prolapse increases in prevalence and incidence in older women and hypoestrogenic conditions. Treatment with native tissue surgery has a fairly high recurrence rate. Mesh-augmented surgery is one of the most promising treatments for pelvic organ prolapse, with high effectiveness and low recurrence. Mesh-augmented surgery has a side effect of tissue erosion. The addition secretome is expected improving tissue integrity and reduce tissue erosion.

Aim:
This study aimed to investigate the effect of adding the umbilical cord mesenchymal stem cell secretome on preventing tissue inflammatory responses, improving tissue integrity, and accelerating wound healing.

Methods:
A total of 32 female New Zealand white rabbit hypoestrogenic model were divided into two groups: the control group with normal mesh and the secretome group with artificial mesh. Hypoestrogenic models were created using the bilateral ovariectomy method. Mesh implantation was performed using a surgical method on hypoestrogenic rabbits. The animals were euthanized on days 7, 14, 28, and 90 after mesh implantation. Histopathology parameters were included angiogenesis formation, fibroblast number, and collagen deposition area.

Results:
The results of this study showed that the number of angiogenesis, fibroblast, and collagen deposition data in the Secretome group showed higher significantly (p<0.05) than those in the Control group on days 7, 14, 28, and 90 post mesh implantation. The formation of new blood vessels (angiogenesis) in the secretome group demonstrated a mean value of 9.81±2.2 compared to 0.37±0.03 in the control. The number of fibroblasts in the secretome group averaged 151.00±8.14, in contrast to 34.00±13.37 in the control group. Collagen formation in the secretome group was also higher, with a mean value of 80.02±6.71 compared to 59.49±4.61 in the control group over 90 days of observation.

Conclusion:
Administration of secretomes from umbilical cord mesenchymal stem cells improved tissue integrity and accelerated wound healing.

Key words: Hypoestrogenic, Angiogenesis, Mesh, Prolapse, Secretome