Particulate silicone for use in periurethral injections: local tissue effects and search for migration

We examined the histologic behavior and migratory tendencies of a silicone-based injectable paste (Macroplastique) with potential application in treating urinary incontinence. Thirteen female dogs were studied. Six received 2 periurethral injections of large-particle paste, with a median diameter of 110 microns, and 7 received similar injections with small-particle paste (median diameter, 73 microns). The paste was radiolabeled with cobalt-57. Histologic analysis was performed at 4 or 9 months. The pathologic appearance revealed intact large-particle injection sites. The small-particle sites had dissipated significantly. This was confirmed by nuclear imaging. Large particles produced an encapsulated fibrous sheath without local migration. There was a histiocytic reaction within the injection site but no granuloma formation. Distant migration was observed in 1 dog (short term, large particle), without an inflammatory response. Migration of silicone occurred locally and distantly in animals that received small particles. X-ray microanalysis confirmed the presence of silicone particles.