Intense Inflammatory Reaction With Porcine Small Intestine Submucosa Pubovaginal Sling or Tape for Stress Urinary Incontinence

John, Tony T.; Aggarwal, N.; Singla, Anand; Santucci, Richard A.

doi:10.1016/j.urology.2008.07.043

Cited by 31 publications

(13 citation statements)

References 18 publications

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“…Based on the results of the present study we are currently in the process of designing an in vivo study of this nature. Importantly, recent reports describing residual porcine DNA on ECM's after their preparation processes have inevitably led to concerns over in vivo biocompatibility [27]. Standardised and thorough decellularistion techniques need to be adopted by researchers to promote host biocompatibility after implantation of the scaffold [16].…”

Section: Discussionmentioning

confidence: 99%

Augmentation Cystoplasty and Extracellular Matrix Scaffolds: An Ex Vivo Comparative Study with Autogenous Detubularised Ileum

et al. 2011

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BackgroundAugmentation cystoplasty (AC) with autogenous ileum remains the current gold standard surgical treatment for many patients with end-stage bladder disease. However, the presence of mucus-secreting epithelium within the bladder is associated with debilitating long-term complications. Currently, decellularised biological materials derived from porcine extracellular matrix (ECM) are under investigation as potential augmentation scaffolds. Important biomechanical limitations of ECMs are decreased bladder capacity and poor compliance after implantation.Methodology/Principal FindingsIn the present ex vivo study a novel concept was investigated where a two-fold increase in ECM scaffold surface-area relative to the resected ileal segment was compared in ovine bladder models after AC. Results showed that bladder capacity increased by 40±4% and 37±11% at 10 mmHg and compliance by 40.4±4% and 39.7±6% (ΔP = 0–10 mmHg) after AC with ileum and porcine urinary bladder matrix (UBM) respectively (p<0.05). Comparative assessment between ileum and UBM demonstrated no significant differences in bladder capacity or compliance increases after AC (p>0.05).ConclusionsThese findings may have important clinical implications as metabolic, infective and malignant complications precipitated by mucus-secreting epithelium are potentially avoided after augmentation with ECM scaffolds.

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Section: Discussionmentioning

confidence: 99%

Augmentation Cystoplasty and Extracellular Matrix Scaffolds: An Ex Vivo Comparative Study with Autogenous Detubularised Ileum

et al. 2011

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“…* represents significant difference between the groups, p value < and Bird 2004;Petter-Puchner 2007;John et al 2008;Wang, Hsu, and Long 2009)…”

mentioning

confidence: 98%

Biocompatibility and Immunophenotypic Characterization of a Porcine Cholecyst–derived Scaffold Implanted in Rats

et al. 2014

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Comparative histomorphological assessment of local response to implanted reference biomaterial, also called biocompatibility testing/evaluation, in an appropriate animal model is a widely practiced safety evaluation procedure performed on biomaterials before clinical use. Standardized protocols and procedures, originally designed for testing synthetic materials, available for the testing/evaluation do not account for the immunogenic potential of a candidate biomaterial. Therefore, it is appropriate to supplement the routine biocompatibility test reports with adjunct data that may provide insight into the immunogenic potential of candidate biomaterials, especially when testing biomaterials that are derived from mammalian sources. This article presents expanded safety evaluation data of a porcine cholecyst-derived scaffold (CDS) intended as a xenogeneic graft. The biocompatibility was tested in rat subcutaneous model in comparison with a reference material and the CDS was found biocompatible. However, when studied by immunohistochemistry and real-time reverse transcription polymerase chain reaction for the number and/or polarization of M1 macrophage, M2 macrophage, cytotoxic T-cell, helper T cell, TH1 cell, and TH2 cell, the CDS appeared to induce a differential local immunopathological tissue reaction despite the similarity in biocompatibility with the reference material. The adjunct data collected were useful for objectively assessing the safety of CDS as a xenograft.

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“…Additionally, the SIS extracellular matrix mesh degrades rapidly by one month after grafting. 31,32 In summary, application of cell-based therapy has demonstrated safety in the short-term, but does not support either strong or durable efficacy conclusions for SUI treatment. The ideal dosage of cells implanted, number of injection and the method of delivery are other important aspects that need to be standardized in future studies.…”

Section: Future Sui Treatmentsmentioning

confidence: 93%

Stress urinary incontinence in women: Current and emerging therapeutic options

Shamout

Campeau

2017

CUAJ

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Surgical management of stress urinary incontinence (SUI) is most commonly achieved by midurethral synthetic sling (MUS) insertion as a first-line surgical option. A great deal of research continues to evolve new management strategies to reach an optimal balance of high efficacy and minimal adverse events. This expert opinion review provides a brief and comprehensive discussion of recent advances and ongoing research in the management of SUI, with an emphasis on single-incision mini-slings, vaginal laser treatment, and cell-based therapy. It is based on data obtained from numerous published meta-analyses and original studies identified through literature search. Single-incision mini-slings appear equally effective initially compared with standard MUS (retropubic or transobturator) for the treatment of female SUI; however, this efficacy lacks durability evidence beyond one-year followup. There is a lack of sufficient clinical evidence to currently confirm long-term safety and effectiveness of cell-therapy and non-ablative vaginal laser therapy, besides suggestion of apparent initial safety. There are still significant challenges to overcome before widespread clinical practice of the latter two modalities. Future research should be aimed at identifying groups of patients who might benefit from these minimally invasive therapeutic options.

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Intense Inflammatory Reaction With Porcine Small Intestine Submucosa Pubovaginal Sling or Tape for Stress Urinary Incontinence

Cited by 31 publications

References 18 publications

Augmentation Cystoplasty and Extracellular Matrix Scaffolds: An Ex Vivo Comparative Study with Autogenous Detubularised Ileum

Augmentation Cystoplasty and Extracellular Matrix Scaffolds: An Ex Vivo Comparative Study with Autogenous Detubularised Ileum

Biocompatibility and Immunophenotypic Characterization of a Porcine Cholecyst–derived Scaffold Implanted in Rats

Stress urinary incontinence in women: Current and emerging therapeutic options

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