title: Factors influencing the long-term success of periurethral collagen therapy in the office.
abstract: BACKGROUND
  Glutaraldehyde crosslinked bovine collagen has been used for periurethral bulking for the treatment of urodynamic stress incontinence since 1989 with variable success. A retrospective study was undertaken to evaluate the factors involved in the long-term success of glutaraldehyde crosslinked bovine collagen used for periurethral bulking in the office.
  
  
  METHODS
  Patients were followed objectively with stress testing after receiving periurethral collagen injection in the office under local anesthesia. Repeat injections were done as necessary during their follow-up appointments. The "success" group was defined as those women who demonstrated negative stress tests for over 1 year following their first injection.
  
  
  RESULTS
  Nineteen of 184 women (10.3%) demonstrated negative stress tests for over 1 year following only one initial injection of glutaraldehyde crosslinked collagen. Their success lasted a mean of 829 days up to the time of follow-up.
  
  
  CONCLUSIONS
  Prior anti-incontinence surgery was the one factor analyzed that showed a trend toward this long lasting success. No other factors were predictive of negative stress tests for over 1 year. Prior anti-incontinence surgery seems to represent a factor involved in the long-term success of periurethral bulking in the office with glutaraldehyde crosslinked bovine collagen for the treatment of urodynamic stress incontinence.
authors.affiliation: Division of Urogynecology, Evanston Continence Center, Evanston Northwestern Healthcare, Northwestern University, Feinberg School of Medicine, Evanston, IL 60201, USA.
authors.forename: Sumana
authors.initials: S
authors.lastname: Koduri
authors.forename: Roger P
authors.initials: RP
authors.lastname: Goldberg
authors.forename: Christina
authors.initials: C
authors.lastname: Kwon
authors.forename: Deborah G
authors.initials: DG
authors.lastname: Dobrez
authors.forename: Peter K
authors.initials: PK
authors.lastname: Sand
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003094:Collagen / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014521:Urethra; D014550:Urinary Incontinence, Stress / Q000628:therapy*
chemical_list: C048470:glutaraldehyde-cross-linked collagen; D003094:Collagen