Biomaterials
A searchable reference to the biomaterials, grafts, prosthetics, stents, catheters, drains, and synthetic adjuncts encountered in functional urology and genitourinary reconstruction — both the materials we implant and the ones patients bring into the clinic after implantation or injection elsewhere.
47 of 47 biomaterials
| Material | Category | Examples / Brands | Use / Key Note |
|---|---|---|---|
| Polypropylene Mesh | Synthetic Meshes | Prolene, Advantage Fit, Gynemesh PS | Midurethral slings, prolapse repair — Type 1 macroporous monofilament is standard |
| Absorbable Synthetic Mesh | Synthetic Meshes | Vicryl (polyglactin), Vypro (mixed) | Historical / limited role; no clear advantage over native tissue at 2 years |
| Coated / Hybrid Mesh | Synthetic Meshes | Polypropylene + collagen coating variants | Theoretical reduction in inflammation and erosion — evidence mixed |
| Bulkamid (PAHG) | Urethral Bulking Agents | Polyacrylamide hydrogel | SUI — 42–70% long-term success; favorable safety profile; no erosions/migration reported |
| Macroplastique (PDMS) | Urethral Bulking Agents | Polydimethylsiloxane microparticles | SUI — 21–80% long-term efficacy; broad evidence base |
| Coaptite | Urethral Bulking Agents | Calcium hydroxyapatite | SUI — 60–75% efficacy; higher temporary urinary retention (34%) |
| Durasphere | Urethral Bulking Agents | Carbon-coated zirconium beads | SUI — associated with lymph-node migration and de novo urgency (25%) |
| Urolastic (PDMS-U) | Urethral Bulking Agents | In-situ polymerizing silicone | SUI — erosion rates up to 24.6% limit use |
| Deflux | Urethral Bulking Agents | Dextranomer/hyaluronic acid | Primarily VUR endoscopic injection — pediatric urology |
| Historical Bulking Agents | Urethral Bulking Agents | Collagen (Contigen), Teflon, autologous fat, chondrocytes | Largely withdrawn or superseded — safety and efficacy concerns |
| Porcine Acellular Collagen Matrix | Biological Grafts | Pelvicol, InteXen LP | Prolapse repair — no clear advantage over native tissue |
| Porcine Small Intestinal Submucosa | Biological Grafts | Surgisis, Stratasis | Historical prolapse and incontinence applications; most products withdrawn |
| Bovine Dermal Graft | Biological Grafts | Permacol | Prolapse and complex reconstruction — limited current use |
| Autologous Rectus Fascia | Autologous Tissue | Pubovaginal sling workhorse | Gold-standard fascial sling; complex SUI; mesh-sling salvage |
| Autologous Fascia Lata | Autologous Tissue | Thigh fascia harvest | Alternative fascial sling source; longer strip available |
| Bowel Segments (GI) | Autologous Tissue | Ileum, colon, appendix | Urinary diversion, augmentation cystoplasty, Mitrofanoff, neobladder — the reconstructive workhorse |
| Inflatable Penile Prosthesis | Prosthetics | AMS 700 CX/LGX, Coloplast Titan | ED unresponsive to medical therapy; silicone cylinders + reservoir + pump |
| Malleable Penile Prosthesis | Prosthetics | AMS Spectra, Coloplast Genesis | Simpler non-inflatable device; lower dexterity requirement |
| Artificial Urinary Sphincter | Prosthetics | AMS 800 (gold standard) | Male SUI after prostatectomy — cuff + pressure-regulating balloon + pump |
| Medtronic InterStim (SNM) | Neuromodulation Devices | InterStim II, InterStim Micro, InterStim X | Sacral neuromodulation for UUI, retention, urgency-frequency, fecal incontinence — IPG + S3 tined lead |
| Axonics SNM System | Neuromodulation Devices | r-SNM, F15, R20 | Sacral neuromodulation; rechargeable or recharge-free options; 15–20+ year battery life |
| PTNS Systems (Office) | Neuromodulation Devices | Urgent PC (Laborie), NURO (Medtronic) | Office percutaneous tibial nerve stimulation — 30-min weekly sessions for OAB / UUI |
| eCoin (ITNS) | Neuromodulation Devices | Valencia Technologies / Boston Scientific | Nickel-sized self-contained implantable tibial stimulator; FDA 2022 for refractory UUI |
| Revi System (ITNS) | Neuromodulation Devices | BlueWind Medical | Battery-free subfascial tibial implant + wearable external power; FDA 2023 for UUI |
| Altaviva (ITNS) | Neuromodulation Devices | Medtronic | Self-contained tibial nerve implant; FDA 2025; placed under LA without sedation/imaging |
| Double-J Ureteral Stent | Ureteral Stents | Percuflex, Polaris, Universa, BioSoft | Workhorse internal upper-tract drainage after stone, UPJ, ureteral, or transplant surgery |
| Nephrostomy Tube (PCN) | Ureteral Stents | Percutaneous 8–24 Fr pigtail | External renal drainage — urosepsis with obstruction, failed retrograde, PCNL tract |
| Nephroureteral Stent | Ureteral Stents | Internal-external (NUS) | Single catheter with combined external and internal drainage; transition between modes |
| Metal / Long-Term Stents | Ureteral Stents | Resonance, Allium, Memokath | 12+ month dwell for malignant obstruction or severe recurrent stricture |
| Foley Catheter | Urinary Catheters | 2-way and 3-way (CBI); latex, silicone, silver-coated | Universal indwelling urethral drainage — balloon retention, 14–24 Fr typical |
| Council Tip Catheter | Urinary Catheters | Central-hole Foley for wire-guided placement | Passage through tight strictures or bladder-neck contractures over a guidewire |
| Coudé (Tiemann) Catheter | Urinary Catheters | Angled tip, Council-coudé variant | Navigating an enlarged prostate, high bladder neck, or prior false passage |
| Suprapubic Catheter (SPT) | Urinary Catheters | Cystofix, Bonanno, Stamey, Foley-through-tract | Long-term bladder drainage bypassing the urethra |
| Self-Retaining Catheter | Urinary Catheters | Malecot (4-winged), de Pezzer (mushroom-tip) | Tip-expansion retention — Mitrofanoff / cecostomy / nephrostomy niche use |
| Intermittent Catheter | Urinary Catheters | Robinson straight, Speedicath, LoFric, closed-system | Clean intermittent self-catheterization (CIC) for neurogenic bladder, Mitrofanoff |
| Jackson-Pratt (JP) Drain | Surgical Drains | 7 mm flat bulb or 10 mm round, silicone | Standard closed-suction wound drain; pelvic / retroperitoneal drainage monitoring |
| Blake Drain | Surgical Drains | Four-channel silicone, trocar-placed | Closed-suction drain with better tissue tolerance — reduced clogging and adherence |
| Penrose Drain | Surgical Drains | Flat rubber or silicone, passive | Passive capillary drainage — abscess, contaminated wounds, Fournier's debridement |
| Decellularized ECM | Tissue Engineering | Xenogenic acellular matrices (bladder, small intestine) | Scaffold for tissue engineering — investigational bladder, urethra, ureter |
| Synthetic Polymer Scaffolds | Tissue Engineering | PLA, PBSu, PLA/PBSu blends, PLGA | Biodegradable scaffolds for urethral tissue engineering |
| Composite Scaffolds | Tissue Engineering | Natural + synthetic blends, 3D bioprinted constructs | Next-generation tissue engineering; stem-cell seeded constructs |
| SpaceOAR Hydrogel | Adjunct & Specialty | PEG hydrogel rectal spacer | Injected between prostate and rectum before prostate radiotherapy |
| UroLift (Prostatic Urethral Lift) | Adjunct & Specialty | Nitinol/stainless steel implants | BPH/BOO — mechanical lateral prostatic lobe retraction |
| Himplant | Adjunct & Specialty | Silicone penile shaft implant | Cosmetic penile augmentation — complications land in reconstructive clinic |
| Glean Urodynamics System | Adjunct & Specialty | Bright Uro — wireless Bluetooth sensor | First wireless catheter-free ambulatory urodynamics — self-coiling intravesical sensor (FDA 2025) |
| Penile Pearls | Foreign Bodies (Non-Medical) | Non-medical implanted beads | Cultural / prison-tattoo practice — infection, erosion, urethral injury |
| Free Silicone Injection | Foreign Bodies (Non-Medical) | Non-medical injected liquid silicone | Illegal cosmetic injection — chronic granulomas, migration, systemic disease |
Organizing Framework
Biomaterials in reconstructive urology span ten functional categories — plus two additional categories included because they enter the clinic even though they are not reconstructive biomaterials per se:
Permanent implanted materials:
- Synthetic meshes — permanent polypropylene dominates; absorbable and hybrid variants exist
- Urethral bulking agents — injectable soft-tissue fillers for SUI
- Biological grafts — xenogenic decellularized collagen matrices (largely fading from prolapse practice)
- Autologous tissue — the patient's own fascia and bowel; the enduring gold standards
- Prosthetics — implanted mechanical devices (IPP, AUS, malleable prosthesis)
- Neuromodulation devices — sacral neuromodulation (InterStim, Axonics) and tibial nerve stimulation (PTNS systems; implantable eCoin, Revi, Altaviva)
Temporary / indwelling devices:
- Ureteral stents & upper-tract drainage — double-J stents, nephrostomy, nephroureteral, and long-term metal stents
- Urinary catheters — Foley, Council tip, coudé, suprapubic, self-retaining, intermittent
- Surgical drains — Jackson-Pratt, Blake, Penrose
Investigational and adjunct:
- Tissue engineering scaffolds — investigational constructs for bladder, urethra, ureter
- Adjunct / specialty — devices encountered in GU practice that don't fit elsewhere (SpaceOAR, UroLift, Himplant)
- Non-medical foreign bodies — penile pearls and free silicone, which reconstructive urologists see as complications rather than implanted materials
See also: Grafts in GU Reconstruction, Flaps in GU Reconstruction, Reconstructive Ladder.