Biomaterials
A searchable reference to the biomaterials, grafts, prosthetics, stents, catheters, drains, and synthetic adjuncts encountered in functional urology and genitourinary reconstruction, including the materials surgeons implant and the ones patients bring into the clinic after implantation or injection elsewhere.
54 of 54 biomaterials
| Material | Category | Examples / Brands | Use / Key Note |
|---|---|---|---|
| Polypropylene Mesh | Synthetic Meshes | Prolene, Advantage Fit, Gynemesh PS | Midurethral slings and abdominal sacrocolpopexy; type I macroporous monofilament PP. US transvaginal POP mesh withdrawn |
| Absorbable Synthetic Mesh | Synthetic Meshes | Vicryl (polyglactin) | 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; no erosion or migration reported in studies included in one qualitative review (Hoe 2021) |
| Macroplastique (PDMS) | Urethral Bulking Agents | Polydimethylsiloxane microparticles | SUI — 21–80% long-term efficacy across heterogeneous studies (Hoe 2021 qualitative review) |
| Coaptite | Urethral Bulking Agents | Calcium hydroxyapatite | SUI — 60–75% long-term success; mean temporary urinary retention 34.2% across reviewed studies (Hoe 2021) |
| Durasphere | Urethral Bulking Agents | EXP carbon-coated graphite beads; original zirconium-oxide beads | SUI — lymph-node migration reported; mean de novo urgency 24.7% across reviewed studies (Hoe 2021) |
| Urolastic (PDMS-U) | Urethral Bulking Agents | In-situ polymerizing silicone | SUI — 17 exposures or erosions in a 65-patient two-center series (de Vries 2017); material excision in 20/110 (18.1%) in a separate cohort (Casteleijn 2020) |
| Deflux | Adjunct & Specialty | 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Bulking Agents | Urethral Bulking Agents | Collagen (Contigen), Teflon, autologous fat, chondrocytes | Largely withdrawn or superseded — safety and efficacy concerns |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-Derived Grafts (Pericardium & Dermis) | Biological Grafts | Peri-Guard, Veritas, Xenform | Peyronie's grafting; historical vaginal POP repair (Xenform no longer sold for US transvaginal POP); crosslinked and non-crosslinked products differ |
| Tutoplast-Processed Allografts | Biological Grafts | Tutoplast pericardium, Tutoplast fascia lata, Tutopatch | Off-the-shelf cadaveric pericardium / fascia for Peyronie's grafting and historical PVS; solvent-dehydrated for room-temp shelf storage |
| Human Acellular Dermal Matrix | Biological Grafts | AlloDerm, FlexHD, Belladerm, Repriza, AxisDermis | Cadaveric ADM for Peyronie's PIG, IPP revision, parastomal hernia; cautionary cosmetic-girth data |
| Autologous Rectus Fascia | Autologous Tissue | Pubovaginal sling material | Fascial sling material; 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 |
| Inflatable Penile Prosthesis | Prosthetics | AMS 700 CX/LGX, Coloplast Titan | ED unresponsive to medical therapy; AMS 700 silicone-layered or Titan Bioflex cylinders + reservoir + pump |
| Malleable Penile Prosthesis | Prosthetics | AMS Spectra, Coloplast Genesis | Simpler non-inflatable device; lower dexterity requirement |
| Artificial Urinary Sphincter | Prosthetics | AMS 800 | Male SUI after prostatectomy — cuff + pressure-regulating balloon + pump |
| ProACT Adjustable Balloons | Prosthetics | Uromedica / Laborie — paired silicone balloons + scrotal port | Male SUI due to ISD for ≥12 months after radical prostatectomy or TURP despite conservative therapy; postoperatively adjustable bilateral balloons near the bladder neck or prostatic apex |
| Male Continence Implants (Slings) | Prosthetics | AdVance / XP, Virtue, ATOMS, Argus, Remeex | Male SUI sling-device family — compressive vs repositioning, fixed vs postoperatively adjustable |
| 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; manufacturer-projected life: F15 recharge-free 10–20 years by setting, R20 rechargeable 20+ years |
| 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 implantable tibial stimulator with primary battery; FDA-approved for UUI after inadequate response or intolerance to conservative treatment, or a successful PTNS trial |
| Revi System (ITNS) | Neuromodulation Devices | BlueWind Medical | Battery-free subfascial tibial implant + wearable external power; FDA 2023 for UUI |
| Altaviva (ITNS) | Neuromodulation Devices | Medtronic | Rechargeable leadless tibial nerve implant; FDA-approved September 2025 for UUI after failure or intolerance of more conservative treatments |
| Double-J Ureteral Stent | Ureteral Stents | Percuflex, Polaris, Universa, BioSoft | Standard 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 | Long-term drainage for malignant obstruction or severe recurrent stricture; follow device-specific surveillance and exchange limits (Resonance: no more than 12 months) |
| Foley Catheter | Urinary Catheters | 2-way and 3-way (CBI); latex, silicone, silver-coated | Balloon-retained urethral drainage when appropriate; 12–14 Fr for clear adult urine, 20–24 Fr for heavy hematuria requiring flushing |
| 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 prostatic angulation or a high bladder neck; avoid blind coudé passage if urethral injury or false passage is suspected |
| Suprapubic Catheter (SPT) | Urinary Catheters | Cystofix, Bonanno, Stamey, Foley-through-tract | Long-term bladder drainage bypassing the urethra |
| 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 or 10 mm flat; 7, 10, 15, or 19 Fr round silicone drains; suction bulb separate or in a kit | Standard closed-suction wound drain; pelvic / retroperitoneal drainage monitoring |
| Blake Drain | Surgical Drains | Four-channel silicone, trocar-placed | Four-channel silicone closed-suction drain designed to resist clogging; occlusion and tissue ingrowth remain possible |
| 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 | Tissue-engineering constructs; 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 |
| Rezūm Water-Vapor System | Adjunct & Specialty | Boston Scientific — convective steam ablation | BPH minimally invasive therapy; 9-s vapor doses to transition zone and median lobe |
| iTind (Temporary Nitinol) | Adjunct & Specialty | Olympus / Medi-Tate — 5–7 day implant | BPH minimally invasive therapy; temporary nitinol implant removed after 5–7 days |
| Aquablation (AquaBeam) | Adjunct & Specialty | Procept BioRobotics — robotic waterjet + TRUS | BPH — studied in 30–80 mL (WATER) and 80–150 mL (WATER II) glands; heat-free waterjet resection; less ejaculatory dysfunction than TURP in WATER |
| Optilume BPH (DCB) | Adjunct & Specialty | Laborie / Urotronic — paclitaxel-coated balloon | BPH; mechanical dilation + paclitaxel delivery; PINNACLE pivotal RCT missed its prespecified IPSS endpoint (12-month treatment vs 3-month sham, 25% margin; p = 0.178) |
| Himplant | Adjunct & Specialty | Silicone penile shaft implant | Cosmetic penile augmentation — complications present to the reconstructive clinic |
| Glean Urodynamics System | Adjunct & Specialty | Bright Uro — wireless Bluetooth sensor | Clinic-based ambulatory urodynamics; intravesical and optional anorectal sensors store pressure and transmit after removal (FDA 2025/2026) |
| Penile Pearls | Foreign Bodies (Non-Medical) | Non-medical implanted objects (beads) | Body modification — 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:
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
- 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, 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 do not fit another category (SpaceOAR, UroLift, Himplant)
- Non-medical foreign bodies. Penile pearls and free silicone, which reconstructive urologists encounter as complications, not as implanted materials
See also: Grafts in GU Reconstruction, Flaps in GU Reconstruction, Reconstructive Ladder.