Transurethral polydimethylsiloxane implantation: a valid option for the treatment of stress urinary incontinence due to intrinsic sphincter deficiency without urethral hypermobility.
OBJECTIVE
In this study we evaluated the 5-year followup results of periurethral polydimethylsiloxane (PDMS) injection for female stress urinary incontinence (SUI) secondary to intrinsic sphincter deficiency (ISD) without hypermobility of the vesicourethral junction.


METHODS
A total of 61 female patients with ISD were enrolled in this prospective, observational study. Preoperative and postoperative assessment included a standardized urogynecologic history with questions regarding urinary function, urogynecologic and neurological physical examination, and urodynamic assessment. All patients underwent periurethral PDMS injection. Patient followup was performed 1, 6, 12, 24, 36, 48 and 60 months after surgery.


RESULTS
At 60 months after injection the SUI cure rate was 18%, the improvement rate was 39% and the failure rate was 43%. The success rate was 57%. Of the patients 45 (74%) subjectively improved with respect to the severity of urinary incontinence. No postoperative early complications were found. At 60 months of followup only minor complications were reported (11%).


CONCLUSIONS
Careful patient selection by optimal diagnostic tools are essential for maximizing the results of urethral bulking agent therapy. PDMS injection in women with SUI due to ISD with limited urethral mobility is a valid, minimally invasive procedure.
Zullo
Marzio Angelo
MA
Department of Obstetrics and Gynecology, Campus Bio Medico University of Rome, Rome, Italy. m.zullo@unicampus.it
Plotti
Francesco
F
Bellati
Filippo
F
Muzii
Ludovico
L
Angioli
Roberto
R
Panici
Pierluigi Benedetti
PB
D000368:Aged; D000369:Aged, 80 and over; D004129:Dimethylpolysiloxanes; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009130:Muscle, Smooth / Q000503:physiopathology; D011446:Prospective Studies; D019736:Prostheses and Implants; D012828:Silicones; D013997:Time Factors; D014521:Urethra; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000601:surgery*
D004129:Dimethylpolysiloxanes; D012828:Silicones; C013830:baysilon