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J Urol. 2009 Feb;181(2):701-4. doi: 10.1016/j.juro.2008.10.027. Epub 2008 Dec 16.

Collagen injection for female urinary incontinence after urethral or periurethral surgery.

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1
Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas 75390-9110, USA.

Abstract

PURPOSE:

We evaluated the result of periurethral collagen injection in incontinent patients after prior urethral surgery.

MATERIALS AND METHODS:

We reviewed the charts of patients who underwent periurethral collagen injection between January 2000 and December 2006 for persistent stress urinary incontinence after a failed suspension procedure or urethral repair. Preoperative assessment included the validated Urogenital Distress Inventory-6 symptom questionnaire, a single global quality of life score, history and physical examination, cystogram while standing and multichannel urodynamics. All patients had a well supported urethra and intrinsic sphincteric deficiency. Outcome measures included questionnaires and 3-dimensional urethral ultrasound at 6 weeks, 6 to 12 months and yearly thereafter. In patients who were still symptomatic after the first injection a repeat injection was considered when there was asymmetrical or low collagen volume on ultrasound, and another therapy was considered when ultrasound findings were adequate.

RESULTS:

In 31 consecutive patients Urogenital Distress Inventory-6 question 3 and quality of life scores decreased after collagen injection (mean volume 5.5 cc). Baseline postoperative collagen volume on ultrasound was 2.6 cc (range 0.8 of 4.8). Of the patients 93% considered themselves clinically improved or cured, 17 of 31 required only 1 injection with a symmetrical configuration in 83%, while 8 received 1 or 2 more injections because of an asymmetrical configuration (75%) and/or low volume. Despite a mean collagen volume of 3.2 cc (range 2 to 4.3) 6 women with persistent stress urinary incontinence underwent a pubovaginal sling procedure. Eight of 25 patients requiring only collagen had stable collagen volume for 2 years without repeat injection.

CONCLUSIONS:

Collagen injection is a viable option with satisfactory results in this complex population.

PMID:
19091340
DOI:
10.1016/j.juro.2008.10.027
[Indexed for MEDLINE]
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