1
|
Campiglio CE, Bidarra SJ, Draghi L, Barrias CC. Bottom-up engineering of cell-laden hydrogel microfibrous patch for guided tissue regeneration. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 108:110488. [PMID: 31924002 DOI: 10.1016/j.msec.2019.110488] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 10/30/2019] [Accepted: 11/23/2019] [Indexed: 01/12/2023]
Abstract
The development of three-dimensional (3D) fibrous networks as platforms for tissue engineering applications has been attracting considerable attention. Opportunely arranged microscaled fibers offer an appealing biomimetic 3D architecture, with an open porous structure and a high surface-to-volume ratio. The present work describes the development of modified-alginate hydrogel microfibers for cell entrapment, using a purpose-designed flow circuit. For microfibers biofabrication, cells were suspended in gel-precursor alginate solution and injected in a closed-loop circuit with circulating cross-linking solution. The flow promoted stretching and solidification of continuous cell-loaded micro-scaled fibers that were collected in a strainer, assembling into a microfibrous patch. The process was optimized to allow obtaining a self-standing cohesive structure. After characterization of the microfibrous patch, the behavior of embedded human mesenchymal stem cells (hMSCs) was evaluated. Microfibers of oxidized alginate modified with integrin-binding ligands provided a suitable 3D cellular microenvironment, supporting hMSCs survival and stimulating the production of endogenous extracellular matrix proteins, such as fibronectin and collagen Type I. Collectively, these features make the proposed microfibrous structures stand out as promising 3D scaffolds for regenerative medicine.
Collapse
Affiliation(s)
- Chiara Emma Campiglio
- i3S - Instituto de Inovação e Investigação em Saúde, Rua Alfredo Allen, 208, 4200-135 Porto, Portugal; Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Milano, via Mancinelli 7, 20131 Milan, Italy; INSTM - National Interuniversity Consortium of Materials Science and Technology, Local Unit Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
| | - Silvia J Bidarra
- i3S - Instituto de Inovação e Investigação em Saúde, Rua Alfredo Allen, 208, 4200-135 Porto, Portugal; INEB - Instituto de Engenharia Biomédica, Universidade do Porto, Porto, Portugal
| | - Lorenza Draghi
- Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Milano, via Mancinelli 7, 20131 Milan, Italy; INEB - Instituto de Engenharia Biomédica, Universidade do Porto, Porto, Portugal
| | - Cristina C Barrias
- i3S - Instituto de Inovação e Investigação em Saúde, Rua Alfredo Allen, 208, 4200-135 Porto, Portugal; INEB - Instituto de Engenharia Biomédica, Universidade do Porto, Porto, Portugal; ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.
| |
Collapse
|
2
|
Starmer B, McAndrew F, Corbett H. A review of novel STING bulking agents. J Pediatr Urol 2019; 15:484-490. [PMID: 31591047 DOI: 10.1016/j.jpurol.2019.08.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 08/28/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The objective of this study was to review the literature to compare the efficacy and complications of polyacrylate-polyalcohol copolymer (PPC) and polyacrylamide hydrogel (PAHG) with the current standard of care, dextranomer/hyaluronic acid (Dx/HA), when used to treat VUR in the paediatric population. METHODS PubMed, Embase and Cochrane databases were searched. Keywords included Vesicoureteral reflux (VUR), endoscopic; endoscopic injection, endoscopic treatment, dulking material, dextranomer/hyaluronic acid copolymer, polyacrylate-polyalcohol copolymer, Deflux, Dexell, Vantris, Bulkamid, outcome, treatment and children. Prospective or retrospective studies comparing PAHG/PPC directly with Dx/HA were included for review. RESULTS Four studies were identified comparing PPC with Dx/HA. All studies showed superior efficacy (on micturating cystourethrogram (MCUG) at 3 months) of PPC over Dx/HA. However, 1 study identified a significantly higher rate of vesicoureteric junction obstruction (VUJO) in the PPC group. One study was identified comparing PAHG with Dx/HA which showed similar efficacy on 3-month MCUG. CONCLUSIONS Current data suggest PPC confers a higher resolution rate of VUR and PAHG confers comparable resolution rates for VUR compared with Dx/HA in the paediatric population. However, the incidence of late-onset VUJO in one study is concerning, and high-quality randomised controlled trials with long-term follow-up are needed before making further recommendations.
Collapse
Affiliation(s)
- Benjamin Starmer
- Alder Hey Children's Hospital NHS Foundation Trust, Eaton Road, Liverpool, L12 2AP, United Kingdom.
| | - Fiona McAndrew
- Alder Hey Children's Hospital NHS Foundation Trust, Eaton Road, Liverpool, L12 2AP, United Kingdom
| | - Harriet Corbett
- Alder Hey Children's Hospital NHS Foundation Trust, Eaton Road, Liverpool, L12 2AP, United Kingdom
| |
Collapse
|
3
|
Ozkuvanci U, Donmez MI, Ozgor F, Erbin A, Pasin Ö, Muslumanoglu AY. Durasphere® EXP: a non-biodegradable agent for treatment of primary Vesico-Ureteral reflux in children. Int Braz J Urol 2018. [PMID: 29522294 PMCID: PMC5996799 DOI: 10.1590/s1677-5538.ibju.2017.0514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction: Durasphere® EXP (DEXP) is a compound of biocompatible and non--biodegradable particles of zirconium oxide covered with pyrolytic carbon. The aim of this study is to evaluate the durability of off-label use of DEXP in the treatment of primary vesicoureteral reflux in children. Materials and Methods: Patients who underwent subureteric injection of DEXP for the correction of primary VUR were retrospectively reviewed. Patients aged >18 years as well as those who had grade-I or -V VUR, anatomic abnormalities (duplicated system, hutch diverticulum), neurogenic bladder or treatment refractory voiding dysfunction were excluded. Radiologic success was defined as the resolution of VUR at the 3rd month control. Success was radiographically evaluated at the end of the first year. Results: Thirty-eight patients (9 boys, 29 girls; mean age, 6.3±2.7 years) formed the study cohort. Forty-six renal units received DEXP (grade II: 22; grade III: 18; grade IV: 6). Mean volume per ureteric orifice to obtain the mound was 0.70±0.16mL. First con- trol VCUG was done after 3 months in all patients. After the first VCUG, 6 patients had VUR recurrence. Short-term radiologic success of DEXP was 84.2%. Rate of radiologic success at the end of the first year was 69.4% (25/32). Lower age (p:0.006) and lower amount of injected material (p:0.05) were associated with higher success rates at the end of 1 year. Conclusion: This is the first study to assess the outcomes of DEXP for treatment of primary VUR in children. After 1 year of follow-up, DEXP had a 69.4% success rate.
Collapse
Affiliation(s)
- Unsal Ozkuvanci
- Department of Urology Haseki Training and Research Hospital, Fatih, Istanbul, Turkey
| | - Muhammet Irfan Donmez
- Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Fatih, Istanbul, Turkey
| | - Faruk Ozgor
- Department of Urology Haseki Training and Research Hospital, Fatih, Istanbul, Turkey
| | - Akif Erbin
- Department of Urology Haseki Training and Research Hospital, Fatih, Istanbul, Turkey
| | - Özge Pasin
- Department of Biostatistics, Istanbul Faculty of Medicine, Istanbul University, Fatih, Istanbul, Turkey
| | | |
Collapse
|
4
|
Blais AS, Bolduc S, Moore K. Vesicoureteral reflux: From prophylaxis to surgery. Can Urol Assoc J 2017; 11:S13-S18. [PMID: 28265309 DOI: 10.5489/cuaj.4342] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Vesicoureteral reflux (VUR) is one of the most common pathologies encountered in pediatric urology. Better understanding of the evolution of VUR and new endoscopic surgical techniques in the last decades have led to major changes in the management of this pathology. However, the treatment algorithm remains complex and is composed of a wide variety of options, from active surveillance to surgical treatment. Herein, we propose to review treatment options for VUR in order to help clinicians make the right treatment decision for the right patient.
Collapse
Affiliation(s)
- Anne-Sophie Blais
- Division of Urology, CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Stéphane Bolduc
- Division of Urology, CHU de Québec-Université Laval, Quebec City, QC, Canada;; CRCHU de Québec-Université Laval, Quebec City, QC, Canada and Axe Médecine Régénératrice
| | - Katherine Moore
- Division of Urology, CHU de Québec-Université Laval, Quebec City, QC, Canada
| |
Collapse
|
5
|
Ramsay S, Blais AS, Morin F, Moore K, Cloutier J, Bolduc S. Polyacrylamide Hydrogel as a Bulking Agent for the Endoscopic Treatment of Vesicoureteral Reflux: Long-Term Results and Safety. J Urol 2016; 197:963-967. [PMID: 27575606 DOI: 10.1016/j.juro.2016.08.093] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE Polyacrylamide hydrogel has been shown to offer good short-term success for the endoscopic treatment of vesicoureteral reflux. Our objective was to provide long-term results of its efficacy and safety. MATERIALS AND METHODS We performed a prospective study using polyacrylamide hydrogel to treat all grades of vesicoureteral reflux. Every patient underwent endoscopic injection of polyacrylamide hydrogel followed by 3-month postoperative renal ultrasound and voiding cystourethrogram. Renal ultrasound was repeated at 12 and 36 months. Treatment success was defined as the absence of de novo or worsening hydronephrosis and the absence of reflux. Safety elements included new or worsening hydronephrosis, calcifications of the injected material and urinary tract infections. RESULTS A total of 76 patients (123 refluxing renal units) were assessed. Median age at surgery was 45 months and median followup was 36 months. Median injected volume of hydrogel per refluxing renal unit was 1.0 ml. The overall success rate 3 months after a single injection was 71%. During long-term followup 68 of 70 eligible patients underwent 12-month ultrasound and 40 of 46 underwent 36-month ultrasound. No upper tract deterioration or bulking agent calcifications were reported. Nine (12%) and 2 patients (3%) presented with nonfebrile and febrile urinary tract infections, respectively. CONCLUSIONS The success rate of polyacrylamide hydrogel for endoscopic treatment of vesicoureteral reflux is comparable to published results of dextranomer hyaluronic acid. The long-term safety data and potential lower cost of polyacrylamide hydrogel provide further support for the use of this nonparticulate bulking agent to treat reflux.
Collapse
Affiliation(s)
- Sophie Ramsay
- Division of Urology, Centre Hospitalier Universitaire de Québec-Université Laval, Québec, Québec, Canada
| | - Anne-Sophie Blais
- Division of Urology, Centre Hospitalier Universitaire de Québec-Université Laval, Québec, Québec, Canada
| | - Fannie Morin
- Division of Urology, Centre Hospitalier Universitaire de Québec-Université Laval, Québec, Québec, Canada
| | - Katherine Moore
- Division of Urology, Centre Hospitalier Universitaire de Québec-Université Laval, Québec, Québec, Canada
| | - Jonathan Cloutier
- Division of Urology, Centre Hospitalier Universitaire de Québec-Université Laval, Québec, Québec, Canada
| | - Stéphane Bolduc
- Division of Urology, Centre Hospitalier Universitaire de Québec-Université Laval, Québec, Québec, Canada.
| |
Collapse
|
6
|
Pai A, Al-Singary W. Durability, safety and efficacy of polyacrylamide hydrogel (Bulkamid(®)) in the management of stress and mixed urinary incontinence: three year follow up outcomes. Cent European J Urol 2015; 68:428-33. [PMID: 26855795 PMCID: PMC4742441 DOI: 10.5173/ceju.2015.647] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 08/14/2015] [Accepted: 09/07/2015] [Indexed: 11/22/2022] Open
Abstract
Introduction There are a myriad of treatment options available for patients suffering with the increasingly prevalent condition of stress urinary incontinence (SUI). The minimally invasive nature of periurethral bulking agents makes them an attractive proposition in the correctly selected patient. There is, however, limited data available on the medium to long term safety and efficacy of this procedure. The aim of our study is to evaluate the outcomes of Polyacrylamide Hydrogel (PAHG) (Bulkamid®) as a periurethral bulking agent at our institution. Material and methods From 2006 to 2011, two hundred and fifty six women underwent periurethral bulking with PAHG in the management of SUI or mixed urinary incontinence (MUI). Women were assessed with at least yearly quality of life and ICIQ questionnaires. Results The majority of patients had the procedure under a local anaesthetic, with a median operative time of 9 minutes. Median follow up was 38 months. 82% of patients reported cure/significant improvement at 3 months. Importantly, this high satisfaction rate was maintained at final follow up and was reflected in both VAS and ICIQ scores. There were no reported adverse reactions and no significant safety concerns. Conclusions We conclude that Bulkamid® injection is an efficacious, minimally invasive, and safe procedure for a selected group of patients with stress incontinence. In our study, PAHG has been shown to be durable and safe.
Collapse
Affiliation(s)
- Aakash Pai
- Worthing Hospital, Department of Urology, Worthing, United Kingdom
| | | |
Collapse
|
7
|
Blais AS, Morin F, Cloutier J, Moore K, Bolduc S. Efficacy of dextranomer hyaluronic acid and polyacrylamide hydrogel in endoscopic treatment of vesicoureteral reflux: A comparative study. Can Urol Assoc J 2015. [PMID: 26225173 DOI: 10.5489/cuaj.2964] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Various bulking agents are available for vesicoureteral reflux (VUR) endoscopic treatment, but their inconsistent success rates and costs are concerns for urologists. Recently, polyacrylamide hydrogel (PAHG) has been shown to have a good overall success rate, which seems comparable to dextranomer hyaluronic acid (Dx/HA), currently the most popular bulking agent. Our objective was to compare the short-term success rate of PAHG and Dx/HA for VUR endoscopic treatment in children. METHODS We performed a prospective non-randomized study using PAHG and Dx/HA to treat VUR grades I to IV in pediatric patients. All patients underwent endoscopic sub-ureteric injection of PAHG or Dx/HA, using the double-HIT technique, followed by a 3-month postoperative renal ultrasound and voiding cystourethrogram. Treatment success was defined as the absence of de novo or worsening hydronephrosis and absence of VUR. RESULTS A total of 90 pediatric patients underwent an endoscopic injection: 45 patients (78 ureters) with PAHG and 45 patients (71 ureters) with Dx/HA. The mean injected volume of PAHG and Dx/HA was 1.1 mL and 1.0 mL, respectively. The overall success rate 3 months after a single treatment was 73.1% for PAHG and 77.5% for Dx/HA. Postoperatively, 1 patient in each group presented with acute pyelonephritis and 2 patients in the Dx/HA group developed symptomatic ureteral obstruction. CONCLUSION Success rates of PAGH and Dx/HA in endoscopic injections for VUR treatment were comparable. The rate of resolution obtained with Dx/HA was equivalent to those previously published. The lower cost of PAHG makes it an interesting option.
Collapse
Affiliation(s)
| | - Fannie Morin
- Department of Urology, CHU de Québec-Université Laval, Quebec, QC
| | | | - Katherine Moore
- Department of Urology, CHU de Québec-Université Laval, Quebec, QC
| | - Stéphane Bolduc
- Department of Urology, CHU de Québec-Université Laval, Quebec, QC
| |
Collapse
|
8
|
Kasi AD, Pergialiotis V, Perrea DN, Khunda A, Doumouchtsis SK. Polyacrylamide hydrogel (Bulkamid®) for stress urinary incontinence in women: a systematic review of the literature. Int Urogynecol J 2015. [DOI: 10.1007/s00192-015-2781-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
9
|
Moore K, Bolduc S. Prospective Study of Polydimethylsiloxane vs Dextranomer/Hyaluronic Acid Injection for Treatment of Vesicoureteral Reflux. J Urol 2014; 192:1794-9. [DOI: 10.1016/j.juro.2014.05.116] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2014] [Indexed: 02/01/2023]
Affiliation(s)
- Katherine Moore
- Division of Urology, Department of Surgery, CHU de Québec, Université Laval, Quebec City, Quebec, Canada
| | - Stéphane Bolduc
- Division of Urology, Department of Surgery, CHU de Québec, Université Laval, Quebec City, Quebec, Canada
| |
Collapse
|
10
|
Baskin LS. This Month in Pediatric Urology. J Urol 2013. [DOI: 10.1016/j.juro.2013.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|