Cyanoacrylic Glue: A Minimally Invasive Nonsurgical First Line Approach for the Treatment of Some Urinary Fistulas

Muto, Giovanni; D’Urso, Leonardo; Castelli, Emanuele; Formiconi, Andrea; Bardari, F.

doi:10.1097/01.ju.0000181809.51544.20

Cited by 53 publications

(42 citation statements)

References 12 publications

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“…No experimental kidney models were found to be comparable to the model used here. This included a histopathological description of the effects of CyA, although a large number of studies postulated the benefits of using the adhesives in urology [48,49]. …”

Section: Discussionmentioning

confidence: 99%

Behaviour of the Biological Adhesives TachoSil®, GelitaSpon®, and a New Elastic Cyanoacrylate (Adhflex®) in Experimental Renal Trauma and Wound Healing

Lloris‐Carsí

García-Cerdá²,

Prieto‐Moure³

et al. 2016

Eur Surg Res

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Background: Renal injuries are relatively frequent in abdominal trauma. In some cases, adhesives and sealants can be used to repair and preserve injured organs. This paper describes the behaviour of three biomaterials - TachoSil®, GelitaSpon®, and a new elastic cyanoacrylate (CyA), Adhflex® - in standardized experimental renal injuries. Methods: Ninety male Wistar rats (300-350 g) were used. A Stiefel Biopsy Punch (8 mm diameter, 3 mm depth) was used to create injuries to the anterior kidney to evaluate wound healing. The animals were divided into five groups: (1) sham (n = 3); (2) control (n = 6), untreated, standard punch injury created on the anterior left kidney; (3) TachoSil® (n = 27), punch injury treated with TachoSil®; (4) GelitaSpon® (n = 27), punch injury treated with GelitaSpon®, and (5) Adhflex® (n = 27), punch injury treated with the new elastic CyA adhesive. The parameters studied were bleeding time, peritoneal adhesions, and histopathological evaluation of wound healing on days 2, 6, and 18, including measurements of the gap between wound edges, inflammatory reaction (CD68), and vascular neoformation (CD31). Results: The bleeding time was significantly shorter (27.7 ± 12.9 s) in the Adhflex® group than in the control (135.8 ± 11.6 s; p < 0.01), TachoSil® (77.5 ± 7.4 s; p < 0.05), and GelitaSpon® (82.5 ± 14.4 s; p < 0.05) groups. The incidence of intraperitoneal adhesions in the animals treated with Adhflex® was 3.6 times higher than in the non-treated group. It was also higher (p < 0.04) than in the groups treated with TachoSil® and GelitaSpon®. The time point with the largest gap between the wound edges and most abundant granulation tissue was at day 6. The largest gap after 18 days was reported for the Adhflex® adhesive. With regard to the markers CD31 and CD68, Adhflex® showed the largest areas 2 days after surgery, but no differences were found after 6 and 18 days versus the other treatments. The expression of the immunomarkers on the renal samples treated with Adhflex® was consistent with a normal healing process. Conclusions: In this experimental model of renal injuries, the new elastic CyA (Adhflex®) resulted in the shortest bleeding time. It offers rapid sealing of the bleeding produced by renal injuries, fixation to adjacent tissues, and reduced occurrences of relapse. The evolution of the scarring is similar to other procedures. Given that traumatic renal injuries are always an emergency due to haemorrhage, Adhflex® might offer additional benefits over conventional treatment methods in human clinical practice.

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Section: Discussionmentioning

confidence: 99%

Behaviour of the Biological Adhesives TachoSil®, GelitaSpon®, and a New Elastic Cyanoacrylate (Adhflex®) in Experimental Renal Trauma and Wound Healing

Lloris‐Carsí

García-Cerdá²,

Prieto‐Moure³

et al. 2016

Eur Surg Res

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“…They also underlined that these adhesives should be considered as a first option in the treatment of urinary fistulas. [34] It was demonstrated that vesicocutaneous fistula (2 cases) occurring following surgery performed to correct bladder extrophy was closed with deepitelization after use of adhesive glue. Safe use of Glubran 2 ® in pediatric cases has been also emphasized.…”

Section: Urethra and Spongiosal Tissuementioning

confidence: 99%

“…Muto et al [34] used CA glues via endoscopic, percutaneous, and endovaginal routes for urinary fistulas developed due to different etiologies. They treated 13 patients with iatrogenic, and inflammatory urinary fistulas using 1-3 mL Glubran ® .…”

Section: Urethra and Spongiosal Tissuementioning

confidence: 99%

Cyanoacrylic tissue glues: Biochemical properties and their usage in urology

Ayyıldız

2017

Turkish Journal of Urology

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Tissue adhesives are being used in medical and cosmetic industries and first aid for a long time. But their everyday usage has not been widespread. Only case report information is available about their usage. Despite good and meaningful results after they were used, there is lack of standard information that gives idea of about in which cases they could be helpful. Nowadays, cyanoacrylates are used in the surgery more frequently. In this review, we wanted to oversee the biochemical properties and the urological utilisation areas of cyanoacrylates.

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“…These fistulae are usually first treated conservatively with urinary and fecal drainage/diversion. If the conservative methods fail, they require surgical repair which can be challenging [4,5]. It is thus desirable to find a technique to treat them with minimal intervention but good results.…”

Section: Discussionmentioning

confidence: 99%

Successful management of urethro-ileal pouch fistula by cynoacrylate glue instillation

Jindal

Sharma

Kamal

et al. 2012

Journal of Pediatric Urology

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Cyanoacrylic Glue: A Minimally Invasive Nonsurgical First Line Approach for the Treatment of Some Urinary Fistulas

Abstract: Cyanoacrylic glue is suitable for endoscopic, percutaneous and endovaginal use. This occlusion therapy represents a safe and minimally invasive approach that might be offered as a first line option for the treatment of urinary fistulas, especially narrow and long tract fistulas.

Cited by 53 publications

References 12 publications

Behaviour of the Biological Adhesives TachoSil®, GelitaSpon®, and a New Elastic Cyanoacrylate (Adhflex®) in Experimental Renal Trauma and Wound Healing

Behaviour of the Biological Adhesives TachoSil®, GelitaSpon®, and a New Elastic Cyanoacrylate (Adhflex®) in Experimental Renal Trauma and Wound Healing

Cyanoacrylic tissue glues: Biochemical properties and their usage in urology

Successful management of urethro-ileal pouch fistula by cynoacrylate glue instillation

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