Reaction to intramural collagen implantation in rabbit bladder

Abstract

Endoscopic correction of vesicoureterorenal reflux in children has limitations, especially with respect to the substance placed beneath the ureterovesical junction. Since Teflon^R injection was followed by granulomatous reactions in canine models, alternative substances are being sought. One of the most promising seems to be glutaraldehyde cross-linked collagen, which has been used in adult and pediatric urology. In seven rabbits glutaraldehyde cross-linked collagen was used to investigate the acute reaction of the bladder wall. In addition, subcutaneous and muscular deposits were made to investigate the reaction of these tissues to Zyplast^R injection. In correctly administered cross-linked collagen deposits in the rabbit bladder, only a few polymorphonuclear cells were seen around the eosinophilic substance in hematoxylineosin slides. The chloroacetate esterase reaction was used to confirm this finding. There was edema around the implants but only a few macrophages were seen. If ulceration after collagen implantation takes place, a definite inflammatory reaction should follow, accompanied by marked eosinophilia. Only sparse foreign-body giant cells were found even in bladders where ulceration of the collagen deposit had taken place. After collagen implantation into hind-leg muscle severe necrosis was documented after 7 days.