title: Incontinence in elderly women: is periurethral collagen an advance?
abstract: OBJECTIVE
  To determine whether periurethral collagen is an effective, safe and practical day-case procedure to control genuine stress incontinence (urethral sphincter incompetence) in the elderly female.
  
  
  METHODS
  Prospective longitudinal study using subjective and objective outcome measures with long term follow up.
  
  
  METHODS
  A teaching hospital tertiary referral centre.
  
  
  METHODS
  Thirty-two women over 65 years of age with a urodynamic diagnosis of genuine stress incontinence.
  
  
  RESULTS
  At one year, 22 women (79%) were subjectively cured or improved, and 14 (50%) were objectively cured; at two years, 18 (69%) and 14 (54%), respectively. Symptoms of urgency, urge incontinence, frequency and nocturia improved, while voiding difficulty remained unchanged. Brief urinary retention was encountered in seven women. No long term side effects or complications were encountered. Urodynamic studies suggest that collagen works by preventing premature bladder neck opening through physical stress, rather than by obstruction. This would account for the slight increase in functional urethral length.
  
  
  CONCLUSIONS
  Contigen collagen is a simple and effective day case procedure as an alternative to major surgery and is without significant morbidity or complication. It is ideal for the elderly.
authors.affiliation: Department of Obstetrics and Gynaecology, St George's Hospital, London, UK.
authors.forename: S L
authors.initials: SL
authors.lastname: Stanton
authors.forename: A K
authors.initials: AK
authors.lastname: Monga
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D003094:Collagen / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007267:Injections; D008137:Longitudinal Studies; D011446:Prospective Studies; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000628:therapy*; D014554:Urination; D014563:Urodynamics
chemical_list: D003094:Collagen