Collagen Injection Therapy for Female Intrinsic Sphincteric Deficiency

Abstract

No AccessJournal of UrologyClinical Urology: Original Article1 Apr 1997Collagen Injection Therapy for Female Intrinsic Sphincteric Deficiency Dennis N. Smith, Rodney A. Appell, J. Christian Winters, and Raymond R. Rackley Dennis N. SmithDennis N. Smith , Rodney A. AppellRodney A. Appell , J. Christian WintersJ. Christian Winters , and Raymond R. RackleyRaymond R. Rackley View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)64949-8AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Since glutaraldehyde cross-linked collagen was approved for use, studies have reported success or improved rates of 63 to 86%. Long-term efficacy with strictly defined outcome criteria has not been reported. We report our experience with collagen injection therapy for female patients with intrinsic sphincteric deficiency to establish efficacy, duration of response and clinical predictors of success. Materials and Methods: A total of 96 women underwent collagen injection via a periurethral approach with local anesthesia. In all patients history, physical examination and video urodynamics documented intrinsic sphincteric deficiency without urethral hypermobility. Continence success was defined as dry or socially continent (minimal leakage requiring 1 or no pad daily even with strenuous activity). Median followup was 14.0 months. Results: Of 94 patients 67.0% achieved continence, 38.3% became dry and 28.7% became socially continent. Of 35 patients who achieved continence with at least 1 year followup 6 had regression. Therefore, 82.9% of those successfully treated remained so at 1 year and none had de novo detrusor instability. An average of 2.1 procedures and 11.9 ml. collagen were required to achieve continence. The 31 patients not achieving success underwent an average of 3.2 procedures with 16.1 ml. collagen. No major complications have occurred to date. Conclusions: Collagen injection achieves a reasonable rate of continence and good durability at 1 year of followup in female patients with intrinsic sphincteric deficiency and no urethral hypermobility. References 1 : Classification of stress urinary incontinence. Neurourol. Urodynam.1984; 2: 103. Google Scholar 2 : Use of collagen injections for treatment of incontinence and reflux. Adv. Urol.1992; 5: 145. Google Scholar 3 : The injection treatment of stress incontinence. Brit. J. Obst. Gynaec.1938; 45: 67. Google Scholar 4 : Treatment of urinary incontinence with sclerosing solutions. Indications, results, complications. Urol. Int.1963; 15: 225. Google Scholar 5 : Polytef augmentation urethroplasty. Correction of surgically incurable urinary incontinence by injection technique. Arch. Surg.1973; 107: 379. Google Scholar 6 : Migration and granulomatous reaction after periurethral injection of Polytef (Teflon). J.A.M.A.1984; 251: 3277. 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Link, Google Scholar From the Department of Urology, The Cleveland Clinic Foundation, Cleveland, Ohio© 1997 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byZULLO M, PLOTTI F, BELLATI F, MUZII L, ANGIOLI R and PANICI P (2018) TRANSURETHRAL POLYDIMETHYLSILOXANE IMPLANTATION: A VALID OPTION FOR THE TREATMENT OF STRESS URINARY INCONTINENCE DUE TO INTRINSIC SPHINCTER DEFICIENCY WITHOUT URETHRAL HYPERMOBILITYJournal of Urology, VOL. 173, NO. 3, (898-902), Online publication date: 1-Mar-2005.CHROUSER K, FICK F, GOEL A, ITANO N, SWEAT S and LIGHTNER D (2018) Carbon Coated Zirconium Beads in β-Glucan Gel and Bovine Glutaraldehyde Cross-Linked Collagen Injections for Intrinsic Sphincter Deficiency: Continence and Satisfaction After Extended FollowupJournal of Urology, VOL. 171, NO. 3, (1152-1155), Online publication date: 1-Mar-2004.BENT A, FOOTE J, SIEGEL S, FAERBER G, CHAO R and GORMLEY E (2018) COLLAGEN IMPLANT FOR TREATING STRESS URINARY INCONTINENCE IN WOMEN WITH URETHRAL HYPERMOBILITYJournal of Urology, VOL. 166, NO. 4, (1354-1357), Online publication date: 1-Oct-2001.PANNEK J, BRANDS F and SENGE T (2018) PARTICLE MIGRATION AFTER TRANSURETHRAL INJECTION OF CARBON COATED BEADS FOR STRESS URINARY INCONTINENCEJournal of Urology, VOL. 166, NO. 4, (1350-1353), Online publication date: 1-Oct-2001.GROUTZ A, BLAIVAS J, KESLER S, WEISS J and CHAIKIN D (2018) OUTCOME RESULTS OF TRANSURETHRAL COLLAGEN INJECTION FOR FEMALE STRESS INCONTINENCE: : ASSESSMENT BY URINARY INCONTINENCE SCOREJournal of Urology, VOL. 164, NO. 6, (2006-2009), Online publication date: 1-Dec-2000.TSCHOPP P, WESLEY-JAMES T, SPEKKENS A and LOHFELD L (2018) COLLAGEN INJECTIONS FOR URINARY STRESS INCONTINENCE IN A SMALL URBAN UROLOGY PRACTICE: TIME TO FAILURE ANALYSIS OF 99 CASESJournal of Urology, VOL. 162, NO. 3 Part 1, (779-783), Online publication date: 1-Sep-1999. Volume 157Issue 4April 1997Page: 1275-1278 Advertisement Copyright & Permissions© 1997 by American Urological Association, Inc.MetricsAuthor Information Dennis N. Smith More articles by this author Rodney A. Appell More articles by this author J. Christian Winters More articles by this author Raymond R. Rackley More articles by this author Expand All Advertisement PDF downloadLoading ...