COMPARATIVE COMPREHENSIVE ASSESSMENT OF THE USE OF VARIOUS VOLUME-FORMING FILLERS IN UROLOGY

Relevance. Modern urological practice demands the search for and implementation of highly effective and biocompatible bulking materials capable of ensuring a stable clinical outcome with minimal risk of complications. The use of bulking agents is particularly significant in reconstructive and functional urology, where both aesthetic and functional outcomes are critically important. Currently, a variety of synthetic and biological materials are employed; however, each possesses certain limitations related to resorption, immunogenic reactions, and the risk of fibrosis. In this regard, the development and comparative analysis of new, combined approaches incorporating autologous components with high biocompatibility is a highly relevant research direction. Aim. To conduct a comparative comprehensive evaluation of the efficacy and biocompatibility of various synthetic and autologous bulking agents used in urological practice, utilizing morphological and morphometric methods of analysis. Materials and methods. The study involved 80 male Belgian rabbits, each receiving a submucosal injection of 0.3 mL of a bulking substrate into the bladder wall. All cases were divided into five groups. At 14 and 30 days post-injection, histological, histochemical, histomorphometric, and morphometric analyses were performed to objectively assess the inflammatory response, vascularization, cellular infiltration, degree of fibrosis, and transplant integrity. Results and discussion. The findings demonstrated that the combination of autologous lipotransplantation with platelet-rich plasma (PRP) exhibited more pronounced vascular network formation, reduced inflammation, and a more homogeneous distribution of transplanted tissue compared to other groups. This indicates high biocompatibility and the potential of this combination as an alternative to synthetic materials, particularly in cases requiring a long-lasting volumizing effect with minimal risk of complications. Conclusion. The combination of PRP with autologous lipotransplantation, as well as the application of Vantris, appears to be among the most promising approaches for achieving a stable and biocompatible bulking effect in the correction of lower urinary tract pathologies. Nevertheless, despite the high short-term biocompatibility of the studied materials, questions regarding their long-term safety, the risk of fibrosis, and potential functional impairments of the bladder remain unresolved and warrant further clinical validation.