Liquid crystal elastomer based dynamic device for urethral support: Potential treatment for stress urinary incontinence.
Liquid crystal elastomer based dynamic device for urethral support: Potential treatment for stress urinary incontinence.
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DOI：
10.1016/j.biomaterials.2022.121912
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发表时间：
2022-11
期刊：
影响因子：
14
通讯作者：
Seelay Tasmim;Zuha Yousuf;Farial S. Rahman;Emily Seelig;Abigail J Clevenger;Sabrina N VandenHeuvel;Cedric P. Ambulo;Shreya A Raghavan;P. Zimmern;M. Romero-Ortega;T. Ware
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文献类型：
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作者：
Seelay Tasmim;Zuha Yousuf;Farial S. Rahman;Emily Seelig;Abigail J Clevenger;Sabrina N VandenHeuvel;Cedric P. Ambulo;Shreya A Raghavan;P. Zimmern;M. Romero-Ortega;T. Ware
压力性尿失禁（Stress urinary incontinence， SUI）的特征是由于咳嗽、打喷嚏或运动时腹内压力增加而导致的不自主尿失禁。SUI影响20-40%的女性人口，并随着年龄的增长而加剧。严重的SUI通常通过在尿道下植入自体或合成吊带来治疗。然而，这些吊带是静态的，如果需要，在植入后，它们的张力不能无创调整。本研究报告了一种基于液晶弹性体（LCEs）的新型器件的制造，该器件能够响应经皮红外光引起的温度升高而改变形状。在瘢痕组织幻影模型中表征了基于lce的装置的形状变化。设计动物体外尿路模型，研究基于lce的装置在红外照明下支持尿失禁和调节吊带张力的效果。最后，对该装置进行了急性植入，并测试了雌性多产新西兰大白兔诱导的张力变化。当嵌入弹性模量为100 kPa的琼脂凝胶中时，LCE装置实现了5.6%±1.1%的驱动。相应的器件温度为44.9℃±0.4℃，周围琼脂温度保持在42.1℃±0.4℃。在模型尿道周围缝合lce基袖带时，漏尿时间明显减少（p < 0.0001），由红外光照射时的5.2min±1min减少至2min±0.5min。多胎兔膀胱颈部植入LCE-CB袖带后，归一化漏点力（LPF）显著升高（p = 0.01）。当装置由红外光照明驱动时，它显著降低（p = 0.023）。这些结果表明，LCE材料可用于制造治疗女性SUI的动态装置。
Stress urinary incontinence (SUI) is characterized by the involuntary loss of urine due to increased intra-abdominal pressure during coughing, sneezing, or exercising. SUI affects 20–40% of the female population and is exacerbated by aging. Severe SUI is commonly treated with surgical implantation of an autologous or a synthetic sling underneath the urethra for support. These slings, however, are static, and their tension cannot be non-invasively adjusted, if needed, after implantation. This study reports the fabrication of a novel device based on liquid crystal elastomers (LCEs) capable of changing shape in response to temperature increase induced by transcutaneous IR light. The shape change of the LCE-based device was characterized in a scar tissue phantom model. Anin vitrourinary tract model was designed to study the efficacy of the LCE-based device to support continence and adjust sling tension with IR illumination. Finally, the device was acutely implanted and tested for induced tension changes in female multiparous New Zealand white rabbits. The LCE device achieved 5.6% ± 1.1% actuation when embedded in an agar gel with an elastic modulus of 100 kPa. The corresponding device temperature was 44.9 °C ± 0.4 °C, and the surrounding agar temperature stayed at 42.1 °C ± 0.4 °C. Leaking time in thein vitrourinary tract model significantly decreased (p < 0.0001) when an LCE-based cuff was sutured around the model urethra from 5.2min ± 1min to 2min ±0.5min when the cuff was illuminated with IR light. Normalized leak point force (LPF) increased significantly (p = 0.01) with the implantation of an LCE-CB cuff around the bladder neck of multiparous rabbits. It decreased significantly (p = 0.023) when the device was actuated via IR light illumination. These results demonstrate that LCE material could be used to fabricate a dynamic device for treating SUI in women.