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Related Experiment Videos

Does technique or material used affect bladder tissue reactions when injecting teflon or silicone paste?

D P Smith1, B E Beegle, H N Noe

  • 1Department of Urology, LeBonheur Children's Medical Center, Tennessee, USA.

Urology
|July 1, 1996
PubMed
Summary

Polytetrafluoroethylene (PTFE) and polydimethylsiloxane (PDMS) paste injections for incontinence show that PDMS is more likely to stay submucosal. Both materials cause similar tissue reactions over time, but pretreatments can cause early necrosis.

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Area of Science:

  • Urology
  • Biomaterials Science
  • Histopathology

Background:

  • Submucosal injections of polytetrafluoroethylene (PTFE) and polydimethylsiloxane (PDMS) pastes are used for treating vesicoureteral reflux and urinary incontinence.
  • The efficacy and safety of these materials may be influenced by injection technique and material properties, potentially affecting particle migration and tissue response.

Purpose of the Study:

  • To investigate the impact of injection technique, paste material (PTFE vs. PDMS), and site pretreatment on local tissue reactions.
  • To evaluate the histological outcomes, including bleb location, inflammation, fibrosis, and epithelial necrosis, at various time points post-injection.

Main Methods:

  • 44 New Zealand white rabbits were used, undergoing submucosal or bladder muscularis injections of PTFE or PDMS paste.

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  • Injection sites were pretreated with saline, epinephrine, or doxycycline, or left untreated.
  • Bladder biopsies were performed at 1 hour, 1 day, 7 days, 1 month, and 6 months for blinded histological evaluation.

    • Main Results:

    • PTFE injections were more frequently found within the muscularis or lost post-autopsy compared to PDMS.
    • Particles were consistently found in retrieved PDMS injection sites.
    • Doxycycline pretreatment led to significant early epithelial necrosis; however, no significant differences in inflammation or fibrosis were observed between PTFE and PDMS at later time points.

    Conclusions:

    • Polydimethylsiloxane (PDMS) paste, when injected correctly, is more likely to remain in the submucosal space compared to polytetrafluoroethylene (PTFE).
    • Pretreatment injections can induce early epithelial necrosis.
    • Both PTFE and PDMS elicit comparable foreign body reactions over extended periods.