Dmochowski R R, Appell R A
North Texas Center for Urinary Control, (RRD), Fort Worth, Texas, USA.
Urology. 2000 Dec 4;56(6 Suppl 1):32-40. doi: 10.1016/s0090-4295(00)01019-0.
Periurethral bulking agents have been used for decades. The only currently available agents (in the United States) include glutaraldehyde cross-linked collagen, autologous fat, and carbon bead technology. Initial subjective cure rates with collagen are acceptable, but with the majority of women requiring reinjection. The risk of allergic phenomena complicates collagen use. Autologous fat injection is initially effective in >50% of women, but resorption and fibrous replacement hamper the stability of the transplanted graft. Polytetrafluoroethylene and silicone are not currently approved by the US Food and Drug Administration because of particle migration. Materials in development include biologic agents such as allogeneic human collagen and autologous cartilage. Developmental synthetic agents include microballoon technology, hyaluronic acid with or without microsphere technology, hydroxylapatite, and a variety of polymeric technologies. Patient selection and material characteristics influence the optimal choice for injectable agent.
尿道周围填充剂已使用数十年。目前（在美国）唯一可用的填充剂包括戊二醛交联胶原蛋白、自体脂肪和碳珠技术。胶原蛋白的初始主观治愈率尚可，但大多数女性需要再次注射。过敏现象的风险使胶原蛋白的使用变得复杂。自体脂肪注射最初在超过50%的女性中有效，但吸收和纤维替代会妨碍移植移植物的稳定性。聚四氟乙烯和硅胶目前未获美国食品药品监督管理局批准，原因是存在颗粒迁移问题。正在研发的材料包括生物制剂，如异体人胶原蛋白和自体软骨。正在研发的合成制剂包括微球技术、有或无微球技术的透明质酸、羟基磷灰石以及各种聚合物技术。患者选择和材料特性会影响可注射填充剂的最佳选择。
