Urinary Bladder – Dextranomer Microspheres
Dextranomer is a hydrophilic dextran polymer that has been used as a 'cleansing agent' for various types of exudating wounds or ulcers. Dextranomer/hyaluronic acid (Dx/HA) is a copolymer in a gel of hyaluronic acid. The dextranomer is in the form of microspheres that are 80 to 200 μm in diameter and do not fragment, eliminating the risk of distance migration. DxHA is injected subureterally into the urinary bladder to correct congenital vesicoureteral reflux, as was done in this case. It is also used to treat stress urinary incontinence.
Dx/HA is a highly viscous solution, nonimmunogenic and biocompatible, with no risk of allergy or granuloma formation. Hyaluronic acid functions as a carrier gel and is resorbed within 2 weeks after injection. The dextranomer microspheres are biodegraded very slowly by hydrolysis and remain at the injection site for up to 4 years. The color of the microspheres when stained with H&E is variable, apparently depending upon the hematoxylin/eosin ratio and the particular product used. Prior to degradation the microspheres resemble and may be confused with embolic microspheres.
Images contributed by Gyu-Yeung Kim (medical student MS4) - @Rosenrot_Path - Yonsei University Health System(Yonsei Severance Hospital, South Korea)
Urinary Bladder – Dextranomer Microspheres
Dextranomer is a hydrophilic dextran polymer that has been used as a 'cleansing agent' for various types of exudating wounds or ulcers. Dextranomer/hyaluronic acid (Dx/HA) is a copolymer in a gel of hyaluronic acid. The dextranomer is in the form of microspheres that are 80 to 200 μm in diameter and do not fragment, eliminating the risk of distance migration. DxHA is injected subureterally into the urinary bladder to correct congenital vesicoureteral reflux, as was done in this case. It is also used to treat stress urinary incontinence.
Dx/HA is a highly viscous solution, nonimmunogenic and biocompatible, with no risk of allergy or granuloma formation. Hyaluronic acid functions as a carrier gel and is resorbed within 2 weeks after injection. The dextranomer microspheres are biodegraded very slowly by hydrolysis and remain at the injection site for up to 4 years. The color of the microspheres when stained with H&E is variable, apparently depending upon the hematoxylin/eosin ratio and the particular product used. Prior to degradation the microspheres resemble and may be confused with embolic microspheres.
Images contributed by Gyu-Yeung Kim (medical student MS4) - @Rosenrot_Path - Yonsei University Health System(Yonsei Severance Hospital, South Korea)