Followup of intraurethral collagen for female stress urinary incontinence.
OBJECTIVE
We studied patient selection parameters and durability of response of collagen injections for female stress incontinence.


METHODS
A total of 187 women 15 to 87 years old (mean age 63) underwent collagen injections for urethral incompetence. Treatment outcome was determined by a change in individual incontinence grades before and after injection.


RESULTS
Of the 187 women 43 (23%) were cured and 97 (52%) improved, while injection failed in 47 (25%). Mean followup in the successful (cured or improved) group was 22 months (range 4 to 69) after the last collagen injection. No difference in outcome was noted in relation to patient age or pretreatment grade of incontinence. Of the 31 patients with bladder instability 13 (42%) had a favorable outcome. No significant difference in outcome was noted in patients with or without hypermobility (p = 0.21235). Patients with type 3 incontinence required the largest amount of collagen for a successful outcome. Persistence of continence in 80 patients who were cured for at least 2 months was plotted on a Kaplan-Meier survival curve. The probability of remaining dry without additional collagen was 71, 58 and 46% at 1 to 3 years, respectively.


CONCLUSIONS
Intraurethral collagen is a safe and well tolerated procedure. Pretreatment bladder instability may be an adverse factor. Patients with or without hypermobility had equal benefit. Long-term durability was noted. If deterioration occurred, repeat collagen injections restored success.
Herschorn
S
S
Department of Surgery, University of Toronto, Sunnybrook Health Science Centre, Ontario, Canada.
Steele
D J
DJ
Radomski
S B
SB
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003094:Collagen / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D012074:Remission Induction; D014550:Urinary Incontinence, Stress / Q000628:therapy*
C048470:glutaraldehyde-cross-linked collagen; D011138:Polytetrafluoroethylene; D003094:Collagen