[The treatment of urinary incontinence by injectables. Analysis of our series].
OBJECTIVE
To determine the efficacy of endoscopical injections for the treatment of stress urinary incontinence (SUI), evaluating its low invasiveness and positive impact on quality of life.


RESULTS
Belween 1997--2003 30 procedures of periurethral injection of various substances for urinary incontinence were performed at our department in women between 47-80 years. All patients were evaluated before surgery, clinically and urodynamically, in accordance to international standardized parameters (filling pressure/flow studies, maximum urethral closure pressure, LPP-leak point pressure). The kind of material employed for injection, surgical technique and satisfaction degree were also evaluated.


RESULTS
The indication for surgery was SUI in 17 cases (56.6%), and mixed urinary incontinence in 73 cases (43.3%). 16 cases (53.3%) had history of previous surgery for SUI. Regarding urodynamic parameters, 19 patients (63.3%) have a maximum urethral closure pressure below 25 H2O cm, and 22 patients (73.3%) had a leak point pressure below 60 H2O cm. Collagen was employed in six cases (20%) and macroplastic in 24 (80%) (14 of them with the MIS system). 22 patients had three injection sites (73.3%). Mean follow-up was 38 months. Continence outcomes were evaluated in relation to complete continence (12 cases, 40%), mild incontinence and patient satisfaction (11 cases, 36.6%), and severe incontinence (7 cases, 23.3%).


CONCLUSIONS
1-To achieve acceptable results it is mandatory to do the best possible indication (Mc Guire type III SUI). 2.-There is an excellent relationship between minimal invasiveness and good results.
Rodríguez Faba
Oscar
O
Servicio de Urología I Hospital Central de Asturias, Oviedo, Asturias, España. oscar.rodriguez@sespa.princast.es
San Martín Blanco
Alfonso
A
Jalón Monzón
Antonio
A
González Alvarez
Roberto Carlos
RC
Alvarez Mújica
Miguel
M
Férnández Gómez
Jesús Ma
JM
Martín Benito
José Luis
JL
Escaf Barmadah
Safwan
S
Regaderas Sejas
Javier
J
D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007267:Injections; D008875:Middle Aged; D014549:Urinary Incontinence / Q000628:therapy*
D001672:Biocompatible Materials