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• W2030882728 abstract "No AccessJournal of UrologyAdult Urology1 Feb 2009Collagen Injection for Female Urinary Incontinence After Urethral or Periurethral Surgery Ginger Isom-Batz and Philippe E. Zimmern Ginger Isom-BatzGinger Isom-Batz More articles by this author and Philippe E. ZimmernPhilippe E. Zimmern More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2008.10.027AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail 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. References 1 : Female Stress Urinary Incontinence Clinical Guidelines Panel summary report on surgical management of female stress urinary incontinence: The American Urological Association. J Urol1997; 158: 875. Link, Google Scholar 2 : Follow-up of TVT operations in 1,113 women with mixed urinary incontinence at 7 and 38 months. Int Urogynecol J Pelvic Floor Dysfunct2008; 19: 391. Google Scholar 3 : Periurethral injection therapy for urinary incontinence in women. Cochrane Database Syst Rev2007; . CD003881. Google Scholar 4 : Transurethral collagen therapy in women. J Urol1995; 154: 1463. Link, Google Scholar 5 : Three-dimensional ultrasonography: an objective outcome tool to assess collagen distribution in women with stress urinary incontinence. Urology2003; 62: 232. Google Scholar 6 : Three-dimensional ultrasonography to assess long-term durability of periurethral collagen in women with stress urinary incontinence due to intrinsic sphincter deficiency. Urology2005; 65: 60. Google Scholar 7 : Standing cystourethrogram: an outcome measure after anti-incontinence procedures and cystocele repair in women. Urology2001; 58: 33. Crossref, Medline, Google Scholar 8 : Predictability of urodynamic findings based on the Urogenital Distress Inventory-6 questionnaire. Urology1999; 54: 461. Google Scholar 9 : Surgery insight: management of failed sling surgery for female stress urinary incontinence. Nat Clin Pract Urol2006; 3: 666. Google Scholar 10 : Treatment options for patients with suboptimal response to surgery for stress urinary incontinence. Curr Med Res Opin2007; 23: 285. Google Scholar 11 : Redo midurethral synthetic sling for female stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct2007; 18: 23. Google Scholar 12 : Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women. Prog Urol2001; 11: 306. Google Scholar 13 : The intravaginal slingplasty operation, a minimally invasive technique for cure of urinary incontinence in the female. Aust N Z J Obstet Gynaecol1996; 36: 453. Google Scholar 14 : Repeat tension-free transvaginal tape (TVT) sling for the treatment of recurrent stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct2002; 13: 133. Google Scholar 15 : Factors predictive of urinary retention after a tension-free vaginal tape procedure for female stress urinary incontinence. J Urol2003; 170: 852. Link, Google Scholar 16 : Second tension-free vaginal tape procedure and mesh retensioning: two possibilities of treatment of recurrent-persistent genuine stress urinary incontinence after a primary tension-free vaginal tape procedure. Int Urogynecol J Pelvic Floor Dysfunct2002; 13: 377. Google Scholar 17 : Shortening of tension-free vaginal tape for the treatment of recurrent incontinence. J Urol2004; 171: 1634. Link, Google Scholar 18 : Tension-free vaginal tape sling for recurrent stress incontinence after transobturator tape sling failure. Int Urogynecol J Pelvic Floor Dysfunct2007; 18: 309. Google Scholar 19 : What do women want?: Interpretation of the concept of cure. J Pelvic Med Surg2003; 9: 273. Google Scholar 20 : The tension-free vaginal tape in women with a non-hypermobile urethra and low maximum urethral closure pressure. Int Urogynecol J Pelvic Floor Dysfunct2007; 18: 727. Google Scholar Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas© 2009 by American Urological AssociationFiguresReferencesRelatedDetails Volume 181Issue 2February 2009Page: 701-704 Advertisement Copyright & Permissions© 2009 by American Urological AssociationKeywordsinjectionsfemaleurinary incontinencecollagenstressurethraMetricsAuthor Information Ginger Isom-Batz More articles by this author Philippe E. Zimmern More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W2030882728 title "Collagen Injection for Female Urinary Incontinence After Urethral or Periurethral Surgery" @default.
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