title: Endoscopic implantation of collagen (GAX) for the treatment of urinary incontinence.
abstract: Sixteen women whose ages ranged from 42 to 73 years (mean 57) and 2 men, aged 76 and 80 years respectively, were treated for urinary stress incontinence with transurethral implantation of submucosal glutaraldehyde cross-linked collagen (GAX); 15 females had had several continence operations previously and 1 female was totally incontinent following low anterior resection of the sigmoid colon for cancer. All but 2 patients received 8 ml GAX in a single operative session under general anaesthesia. Before implantation, patients underwent urodynamic evaluation, cystoscopy, urinary stress test and the two-thirds capacity pad weighing test. Post-operative evaluations were carried out after 3, 6 and 9 months and included urinary flow rate, urine analysis, residual urine determination and the two-thirds pad weighing test. The results were encouraging. After 3 months, 8/18 patients were cured, 7/18 had improved and 3/18 had failed to respond. Nine months post-operatively, 7 patients were still continent, 8 had improved and 3 remained unchanged. One of the improved group had a reinjection 18 months post-operatively and has been continent since then. We feel that GAX collagen injection is a safe and easy method for the treatment of urinary stress incontinence; it has no observable or measurable morbidity.
authors.affiliation: Department of Urology, Wilhelminen Hospital, Vienna, Austria.
authors.forename: H
authors.initials: H
authors.lastname: Kieswetter
authors.forename: M
authors.initials: M
authors.lastname: Fischer
authors.forename: L
authors.initials: L
authors.lastname: Wöber
authors.forename: J
authors.initials: J
authors.lastname: Flamm
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003094:Collagen / Q000008:administration & dosage*; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011379:Prognosis; D019736:Prostheses and Implants; D014521:Urethra / Q000601:surgery; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics
chemical_list: D003094:Collagen