Migrated Bulking Material (Solesta) Presenting as a Vaginal "Cyst": Histopathologic and Chemical Analytical Features

Area of Science:

• Urogynecology
• Gastroenterology
• Biomaterials Science

Background:

• Fecal incontinence is a common condition impacting quality of life.
• Bulking agent injections, using non-animal stabilized hyaluronic acid and dextranomer, are a recognized treatment for fecal incontinence.
• These agents aim to augment the anal sphincter's function.

Observation:

• A patient with prior fecal incontinence bulking procedures presented with a vaginal cyst.
• The excised vaginal cyst was examined histopathologically.
• The examination revealed the presence of the bulking agent within the excised tissue.

Findings:

• Histopathology confirmed the migration of the non-animal stabilized hyaluronic acid and dextranomer bulking agent from its intended injection site.
• This migration resulted in the formation of a vaginal cyst-like structure.
• The case highlights a rare, yet documented, adverse event associated with bulking agent injections.

Implications:

• This case underscores the importance of considering rare complications, such as agent migration, following bulking procedures for fecal incontinence.
• Awareness of potential migration is crucial for accurate diagnosis and management in urogynecology and gastroenterology.
• Further research into the long-term behavior and potential migration patterns of bulking agents may be warranted.