A tissue-engineered mesh fabricated with adiposederived mesenchymal stem cells (AD-MSCs) cultured on a silk fibroin scaffold is evaluated for use in female pelvic reconstruction.Thirty-five female Sprague Dawley rats were divided into four groups.Group A (n=10) were implanted with polypropylene meshes, Group B (n =10) with silk fibroin scaffolds and Group C (n =10) with tissue-engineered meshes.Group D (n=5) acted as the tissue control.The tissueengineered mesh was produced as follows.AD-MSCs were obtained from adipose tissue of rats designated to Group C.The cells were seeded onto a silk fibroin scaffold, cultured and then observed by scanning electron microscopy (SEM).Histological studies of these meshes were performed at 4 and 12 weeks after implantation and mechanical testing was carried out on all groups before implantation and at 12 weeks after implantation.AD-MSCs displayed fibroblast-like shapes and were able to differentiate into adipocytes or fibroblasts.SEM observation showed that AD-MSCs proliferated and secreted a matrix onto the silk fibroin scaffolds.After implantation of the scaffolds into rats, histological analysis revealed better organized newly formed tissue in Group C than in controls.Group C also had a similar failure force (2.67±0.15 vs 2.33±0.38 N) and a higher Youngs modulus (2.99±0.19 vs 1.68±0.20 MPa) than a normal vaginal wall, indicating the potential of this tissue-engineered approach.AD-MSCs were validated as seed cells for tissue engineering.The silk fibroin scaffold thus shows promise for application with AD-MSCs in the fabrication of tissue-engineered mesh with good biocompatibility and appropriate mechanical properties for pelvic floor reconstruction.