Supplementary Material for: Comparison of Morphological and Histological Characteristics of Human and Sheep: Sheep as a Potential Model for Testing Midurethral Slings in vivo

<b><i>Introduction:</i></b> 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. <b><i>Methods:</i></b> 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. <b><i>Results:</i></b> 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. <b><i>Conclusion:</i></b> 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.

<b><i>引言：</i></b> 本研究基于以下两点将绵羊评估为尿道吊带术体内临床前评价的潜在模型：(1) 绵羊阴道的解剖学测量数据；(2) 聚丙烯（polypropylene, PP）吊带的组织整合效果与宿主反应。
<b><i>方法：</i></b> 本研究共纳入8只经产雌性绵羊。其中3只接受模拟人类中段尿道吊带术所采用的无张力阴道吊带术式的手术操作，并于术后6个月实施安乐死。本研究采集以下测量指标：阴道长度、牵拉状态下的最大阴道宽度、耻骨联合长度以及耻骨至手术切口的距离。对获取的绵羊及人类吊带植入物标本进行苏木精-伊红（hematoxylin and eosin, HE）染色，以评估宿主反应。
<b><i>结果：</i></b> 几何测量结果显示，人类与绵羊的相关指标具有相似性。绵羊的阴道解剖结构允许开展与人类手术类似的吊带植入操作，所有受试绵羊均顺利康复，未出现异常情况。绵羊与人类的组织学对比分析表明，二者植入物周围的宿主反应及胶原沉积情况相似，证实绵羊模型可用于生物材料宿主反应的评价。
<b><i>结论：</i></b> 绵羊阴道长度与人类相当。绵羊与人类标本中，聚丙烯（PP）吊带的组织整合效果与宿主反应均表现为慢性炎症伴材料周围大量胶原沉积，由此凸显绵羊可作为中段尿道吊带术临床前测试的潜在动物模型。