Stenberg A M, Sundin A, Larsson B S, Läckgren G, Stenberg A
Department of Obstetrics and Gynecology, Uppsala University Hospital, Sweden.
J Urol. 1997 Nov;158(5):1937-41. doi: 10.1016/s0022-5347(01)64185-5.
In recent years endoscopic treatment of stress incontinence and vesicoureteral reflux has been introduced. Reports of possible particle migration of the injected material to distant organs in humans and experimental animals have led to a search for biological nonmigration products. An implant found to have a good clinical effect in these conditions is dextranomer in hyaluronan. We performed this study in rabbits to investigate the possible migration of dextranomer particles.
125Iodine labeled dextranomer particles were injected into the submucosal space of rabbit bladders, and samples of blood and various tissues were examined for radioactivity at scheduled intervals during a 28-day period. Furthermore, whole body autoradiography was performed 1 day, and 1 and 4 weeks after injection.
Radioactivity was found in blood samples and in all tissues but it remained at the background activity level except in the thyroid, where uptake representing free 125iodine was detected. In the bladder 41 and 45% of the injected dose remained within the bladder wall 1 day and 4 weeks, respectively, after injection. The remainder of the dose probably disappeared from the bladder wall by leakage into the urine shortly after deposition, as indicated by the finding of 10-fold higher urine radioactivity levels at day 1 than at day 28 after injection.
No distant migration of dextranomer particles occurs after submucosal injection of such an implant in the rabbit bladder wall.
近年来,压力性尿失禁和膀胱输尿管反流的内镜治疗方法已被引入。有报道称,在人类和实验动物中,注射材料的颗粒可能会迁移至远处器官,这促使人们寻找不会发生迁移的生物材料。一种在这些病症中显示出良好临床效果的植入物是透明质酸葡聚糖微球。我们在兔子身上进行了这项研究,以调查葡聚糖微球颗粒是否可能发生迁移。
将碘-125标记的葡聚糖微球颗粒注射到兔膀胱黏膜下层,在28天的时间内按预定间隔对血液和各种组织样本进行放射性检测。此外,在注射后1天、1周和4周进行全身放射自显影。
在血液样本和所有组织中均检测到放射性,但除甲状腺外,放射性均维持在本底活性水平,甲状腺中检测到代表游离碘-125的摄取。注射后1天和4周,分别有41%和45%的注射剂量留在膀胱壁内。注射后第1天尿液中的放射性水平比第28天高10倍,这表明其余剂量可能在沉积后不久通过漏入尿液而从膀胱壁消失。
在兔膀胱壁黏膜下注射此类植入物后,葡聚糖微球颗粒不会发生远处迁移。