Injectable biomaterials for incontinence and vesico-ureteral reflux: current status and future promise.
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.
Tsai
Chi-Chun
CC
Alcon Research, Ltd., 6201 South Freeway, Mail Stop R1-18, Fort Worth, Texas 76134, USA. chi-chun.tsai@alconlabs.com
Lin
Victor
V
Tang
Liping
L
D000328:Adult; D000818:Animals; D001672:Biocompatible Materials / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005549:Foreign-Body Reaction; D006801:Humans; D020100:Hydrogels / Q000737:chemistry / Q000378:metabolism / Q000627:therapeutic use; D007267:Injections; D008297:Male; D008422:Materials Testing; D051379:Mice; D008875:Middle Aged; D011134:Polysaccharides / Q000737:chemistry / Q000276:immunology / Q000627:therapeutic use; D019736:Prostheses and Implants; D014550:Urinary Incontinence, Stress / Q000628:therapy*; D014718:Vesico-Ureteral Reflux / Q000628:therapy*
D001672:Biocompatible Materials; D020100:Hydrogels; D011134:Polysaccharides