Bladder Tattooing in the Urological Armamentarium: An Experimental Study

Abstract

Objective: To evaluate the feasibility of tattooing of the bladder urothelium using different stains. Methods:The study was performed on 20 healthy male and female dogs, which were divided into 4 groups according to the injected material. The first group (4 animals) was injected with hydrated iron (II) sulphate. The second group (4 animals) was injected with methylene blue added to hydrated iron (II) sulphate. The third group (8 animals) was injected with India ink, and the fourth group (4 animals) was injected with methylene blue. The procedure was performed under general anesthesia. The doses as well as the injection technique were standardized. Re-exploration with sacrifice of the dogs was performed after 40 days. The bladder was examined grossly for dye retention. Bladder, spleen, and liver specimens were sent for histopathological examination. results: Tattooing was performed successfully without any immediate reaction. Postoperative complications occurred in a single case in the form of vesicocutaneous fistula. At re-exploration, the dye was retained in both the first and second groups, and there was no difference in color intensity. Methylene blue increased the local inflammatory changes. The third and the fourth groups failed to retain the dye. Local reaction at the site of injection, as well as in the bladder, was present in all cases, being most severe in the third group. In cases of the first, second, and third groups the inflammatory reaction involved the liver with hepatic degeneration up to cirrhotic changes. Histopathological examination showed the presence of ferrous particles in the submucosa as well in the detrusor muscles. The presence of ferrous particles was also detected in the spleen. conclusion: In our study, tattooing the bladder urothelium was successful. Despite the side effects of the used materials, tattooing remains feasible; however, the type of material, dose titration, and long follow-up are needed to detect the most suitable material.cItAtION: UroToday Int J. 2013 April;6(2):art 26. http://dx.