title: Collagen injection for the treatment of incontinence after cystectomy and orthotopic neobladder reconstruction in women.
abstract: OBJECTIVE
  We determine the clinical efficacy of endoscopically injected collagen for the treatment of new onset urinary incontinence in women following cystectomy and orthotopic neobladder.
  
  
  METHODS
  Three women 58 to 74 years old underwent transurethral collagen injection for stress urinary incontinence following cystectomy and orthotopic neobladder. Before cystectomy 2 women denied having any stress urinary incontinence while 1 complained of mild incontinence. Onset of incontinence following cystectomy and neobladder formation ranged from 8 months to 3 years, and average pad use ranged from 3 to 5 per 24-hour period. All patients underwent video urodynamic evaluation before collagen injection. Neobladder capacity was 180 to 400 cc and Valsalva leak point pressures ranged from 30 to 60 cm. water.
  
  
  RESULTS
  A total of 6 injections were given, including 3 injections in 1 patient, 2 in 1 and 1 in 1. All 3 women had significant improvement or became dry with initial injection but required repeat injections to maintain improved continence status. At 7 to 8 months after the last injection 1 woman was dry, 1 used 1 or no pad daily and 1 reported no durable change in stress urinary incontinence.
  
  
  CONCLUSIONS
  Collagen injection appears to be a successful, minimally invasive treatment for new onset stress urinary incontinence following cystectomy and orthotopic neobladder in women.
authors.affiliation: Department of Surgery, University of Michigan Medical Center, Ann Arbor, USA.
authors.forename: M B
authors.initials: MB
authors.lastname: Tchetgen
authors.forename: M G
authors.initials: MG
authors.lastname: Sanda
authors.forename: J E
authors.initials: JE
authors.lastname: Montie
authors.forename: G J
authors.initials: GJ
authors.lastname: Faerber
mesh_terms: D000368:Aged; D003094:Collagen / Q000008:administration & dosage*; D015653:Cystectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007267:Injections; D014547:Urinary Diversion / Q000009:adverse effects*; D014550:Urinary Incontinence, Stress / Q000209:etiology* / Q000628:therapy*
chemical_list: D003094:Collagen