Effects of Mesenchymal Stem Cells and Heparan Sulfate Mimetics on Urethral Function and Vaginal Wall Biomechanics in a Simulated Rat Childbirth Injury Model

This study investigated how simulated childbirth injury alters vaginal wall biomechanics and whether regenerative therapies using mesenchymal stem cells (MSCs) or heparan sulfate mimetics (RGTA®) can restore tissue function. A rat model combining pudendal nerve crush and vaginal distension produced significant reductions in vaginal wall stiffness and altered anisotropic mechanical behavior. Biaxial mechanical testing demonstrated that MSC treatment restored vaginal wall stiffness in both longitudinal and transverse directions, whereas RGTA® treatment increased tissue anisotropy without fully restoring stiffness. Histological analysis showed corresponding changes in collagen and elastin organization, linking extracellular matrix remodeling to biomechanical recovery. The findings highlight distinct regenerative mechanisms by which cellular and non-cellular therapies influence pelvic floor tissue mechanics after childbirth injury.