title: Delayed hypersensitivity and systemic arthralgia following transurethral collagen injection for stress urinary incontinence.
abstract: OBJECTIVE
  During a prospective cohort study to determine the effectiveness of and adverse effects associated with transurethral collagen injection for treatment of stress urinary incontinence in women, we observed 3 cases of delayed allergic reaction at the skin test site associated with arthralgia.
  
  
  METHODS
  A total of 337 women with at least a 1-year history, physical findings and urodynamic abnormalities consistent with stress urinary incontinence, who required pads or protective clothing and who had no or only grade 1 cystocele were enrolled in this prospective cohort study. Adverse effects were documented by a third party at each followup.
  
  
  RESULTS
  Delayed reaction at the skin test site occurred in 3 patients (0.9%), and was associated with arthralgias in 2.
  
  
  CONCLUSIONS
  The incidence and systemic nature of this type of reaction suggest that gluteraldehyde cross-linked collagen injection is not as innocuous as previously believed. Patients should be counseled regarding the unknown long-term outcome of this complication. Before treatment clinicians should consider double skin testing.
authors.affiliation: Department of Surgery, University of British Columbia, Vancouver, Canada.
authors.forename: L
authors.initials: L
authors.lastname: Stothers
authors.forename: S L
authors.initials: SL
authors.lastname: Goldenberg
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D018771:Arthralgia / Q000209:etiology* / Q000473:pathology; D003094:Collagen / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D004342:Drug Hypersensitivity / Q000209:etiology*; D005260:Female; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000209:etiology* / Q000473:pathology; D007267:Injections; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014550:Urinary Incontinence, Stress / Q000188:drug therapy*
chemical_list: D003094:Collagen