{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T22:25:28Z","timestamp":1783635928881,"version":"3.55.0"},"reference-count":24,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"CMHS, AGU","award":["G1-AGU-4-23"],"award-info":[{"award-number":["G1-AGU-4-23"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Hyaluronic acid (HA)-based urethral bulking agents are promising for the treatment of stress urinary incontinence (SUI), but migration risks to distant organs remain a concern. This study evaluated the migration and cytotoxicity of Zhoabex G\u00ae, an HA-based bulking agent, in a female rabbit model. Twenty-seven female New Zealand white rabbits were randomized into control (no injection), sham (saline), and experimental (Zhoabex G\u00ae) groups (n = 9 each). After 5 months, tissues from the kidney, lung, liver, and spleen were analyzed using quantitative RT-PCR for hyaluronan synthase (HAS1, HAS2, HAS3) and hyaluronidase (HYAL2) gene expression, and ELISA for HA concentrations. No significant differences in gene expression were observed across groups (p \u2265 0.05, range: 0.166\u20130.997), with experimental fold change values near sham baselines (e.g., kidney HAS2: 0.987 \u00b1 0.071, p = 0.422). Similarly, HA concentrations showed no group differences (p = 0.577; e.g., kidney: 119.2\u2013121.8 ng\/mL), reflecting organ-specific basal levels. These findings indicate that Zhoabex G\u00ae remains localized at the urethral injection site, with no evidence of migration or cytotoxicity in distant organs. The biodegradable and non-particulate nature of Zhoabex G\u00ae further supports its safety for SUI treatment, warranting further clinical investigation.<\/jats:p>","DOI":"10.3390\/ijms262110286","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T01:14:02Z","timestamp":1761182042000},"page":"10286","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Assessment of Migration of the Urethral Bulking Agent Zhoabex G\u00ae from the Urethral Injection Site to the Distant Organs in a Rabbit Model"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7945-5037","authenticated-orcid":false,"given":"Bhagath Kumar","family":"Potu","sequence":"first","affiliation":[{"name":"Department of Anatomy, College of Medicine and Health Sciences, Arabian Gulf University, Manama P.O. Box 26671, Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9414-7059","authenticated-orcid":false,"given":"Diaa","family":"Rizk","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, College of Medicine and Health Sciences, Arabian Gulf University, Manama P.O. Box 26671, Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1178-8625","authenticated-orcid":false,"given":"Muna","family":"Aljishi","sequence":"additional","affiliation":[{"name":"Princess Al Jawhara Center for Molecular Medicine, Genetics and Inherited Diseases, Department of Molecular Medicine, College of Medicine and Health Sciences, Arabian Gulf University, Manama P.O. Box 26671, Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6660-3627","authenticated-orcid":false,"given":"Ameera","family":"Sultan","sequence":"additional","affiliation":[{"name":"Princess Al Jawhara Center for Molecular Medicine, Genetics and Inherited Diseases, Department of Molecular Medicine, College of Medicine and Health Sciences, Arabian Gulf University, Manama P.O. Box 26671, Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3673-990X","authenticated-orcid":false,"given":"Wael Amin","family":"Nasr El-Din","sequence":"additional","affiliation":[{"name":"Department of Anatomy, College of Medicine and Health Sciences, Arabian Gulf University, Manama P.O. Box 26671, Bahrain"},{"name":"Department of Human Anatomy and Embryology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Salvatore","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology Unit, Vita-Salute San Raffaele University, IRCCS San Raffaele Hospital, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8276-4535","authenticated-orcid":false,"given":"Safa","family":"Taha","sequence":"additional","affiliation":[{"name":"Princess Al Jawhara Center for Molecular Medicine, Genetics and Inherited Diseases, Department of Molecular Medicine, College of Medicine and Health Sciences, Arabian Gulf University, Manama P.O. Box 26671, Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1111\/luts.12372","article-title":"Formative Macroplastice volume and configuration effect in women with stress urinary incontinence secondary to intrinsic sphincter deficiency: Retrospective review","volume":"13","author":"Carroll","year":"2021","journal-title":"Low. Urin. Tract. Symptoms"},{"key":"ref_2","first-page":"100438","article-title":"Microarchitectural changes in the urethral wall after injecting hyaluronic acid based bulking agent (Zhoabex G): An experimental study in New Zealand white female rabbits","volume":"41","author":"Potu","year":"2025","journal-title":"Transl. Res. 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