Sevim Ecem Ünlü Ballı, Hatice Sürer, Pelin Seçken, Gökhan Berktuğ Bahadır, Gülçin Şimşek, Suzi Demirbağ, İlhami Sürer
Türkiye Çocuk Hastalıkları Dergisi - 2026;20(2):98-103
Objective: In failed cases treated with the endoscopic sub-ureteric injection method, no residue from the previous injection material was found during cystoscopy at the second injection. The clinical observation of an increased incidence of recurrent reflux in girls than in boys reminds us that bladder gender may influence the stability of the injection material. The aim of the study was to determine whether there is a gender-related difference in the durability of the subureteric injection material. Material and Methods: Twenty male and female Wistar-Albino rats were evenly divided into four groups. The experimental group received a submucosal injection of 0.1cc dextranomer hyaluronic acid copolymer (Dexell(R)) into the bladder. In addition, the control group received 0.1cc of 0.9% NaCl. Tissue hyaluronidase activity was measured biochemically using the ELISA method. The injection sites were assessed histopathologically and immunohistochemically with CD31 and CD34 Rabbit Monoclonal Antibodies. Results: Biochemically, tissue hyaluronidase activity in female groups was statistically significantly higher than in males. Histopathologically, there were no significant differences between the genders or between the experimental and control groups in relation to fibrosis formation. Regarding immunohistochemistry, angiogenesis was statistically significantly higher in all females, regardless of whether they were in the study or control group, compared to males. Concerning progenitor cell activity, there is no difference between the genders, whereas the difference between the study and control groups was significant. Conclusion: Biochemically, higher hyaluronidase activity in the female rat bladder may cause a faster breakdown of the hyaluronic acid compound in the injection material. The high permeability of inflammatory cells in the female rat bladder, as detected histochemically, may accelerate the destruction process with the aid of lytic enzymes in these cells.
