Periurethral fat injection in the treatment of recurrent genuine stress incontinence.
OBJECTIVE
We evaluated the efficacy, safety and mechanism of periurethral fat injection in the treatment of recurrent genuine stress incontinence.


METHODS
Periurethral fat injections were performed in 26 patients for the treatment of recurrent genuine stress incontinence. A complete urogynecological study, including a 1-hour pad test, urodynamic studies and chain urethrocystography were done in each case and were repeated at least 3 months after operation. Each patient was followed for at least 12 months.


RESULTS
Of 26 patients 13 (50%) were dry after operation and 4 (15.4%) showed improvement and were satisfied with the results of the operation, giving a total success rate of 65.4%. There were 6 cases of immediate postoperative minor complications (23%). Average volume of injected fat was 14.8 +/- 4.8 cc, which did not affect the success rate. Preoperative and postoperative chain urethrocystographic values for bladder neck descent in reference to the pubosacral tip line showed no statistical difference between successfully and unsuccessfully treated groups. Urodynamic studies in all cases showed no differences relating to operation. However, minimal urethral resistance increased from 0.122 +/- 0.061 to 0.205 +/- 0.134 (p = 0.023) in the treatment success group. This change was not demonstrated in the treatment failure group.


CONCLUSIONS
Periurethral fat injection for the treatment of recurrent genuine stress incontinence is a simple technique that works by the increment of urethral resistance. It has an acceptable success rate without financial outlay for the injected material.
Su
T H
TH
Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.
Wang
K G
KG
Hsu
C Y
CY
Wei
H J
HJ
Yen
H J
HJ
Shien
F C
FC
D000273:Adipose Tissue; D000328:Adult; D006801:Humans; D007267:Injections; D008875:Middle Aged; D012008:Recurrence; D014521:Urethra; D014550:Urinary Incontinence, Stress / Q000628:therapy*