Injectable biomaterials for incontinence and vesico-ureteral reflux: current status and future promise

J Biomed Mater Res B Appl Biomater. 2006 Apr;77(1):171-8. doi: 10.1002/jbm.b.30428.

Abstract

Many injectable biomaterials have been produced as bulking agents for compression of urethral sphincter or ureteral orifice for treating adult stress incontinence or vesico-ureteral reflux in pediatrics. The agents being developed include glutaraldehyde crosslinked collagen, dextranomer/hyaluronic acid copolymer, pyrolytic carbon-coated zirconium oxide beads, polydimethyl-siloxane microparticles, polytetrafluoroethylene paste, autologous fats, autologous chondrocytes, and others. Though less invasive nature of these agents has gained their popularity as a quick solution of the disease symptoms, most of such treatments fail to produce good long-term efficacy. The failure is likely caused by the rapid degradation of material implants and the lack of tissue regeneration/integration properties. We thus believe that a good injectable biomaterial for incontinence should possess the following two properties: (1) to resist degradation and to reside in the implantation sites for a long period of time or (2) to enhance tissue regeneration and to establish permanent periurethral or subureteric tissue. Here we report some recent results for supporting this hypothesis.

MeSH terms

  • Adult
  • Animals
  • Biocompatible Materials* / administration & dosage
  • Biocompatible Materials* / therapeutic use
  • Female
  • Foreign-Body Reaction
  • Humans
  • Hydrogels / chemistry
  • Hydrogels / metabolism
  • Hydrogels / therapeutic use
  • Injections
  • Male
  • Materials Testing
  • Mice
  • Middle Aged
  • Polysaccharides / chemistry
  • Polysaccharides / immunology
  • Polysaccharides / therapeutic use
  • Prostheses and Implants*
  • Urinary Incontinence, Stress / therapy*
  • Vesico-Ureteral Reflux / therapy*

Substances

  • Biocompatible Materials
  • Hydrogels
  • Polysaccharides