title: Use of periurethral injections of polyacrylamide hydrogel for treating post-vesicovaginal fistula closure urinary stress incontinence.
abstract: OBJECTIVE
  Following successful closure of obstetric genitourinary fistula, stress urinary incontinence (SUI) is a common and challenging problem. Despite many decades of various treatment options, the effective management of post-fistula SUI remains unresolved. This study aims to assess the feasibility of periurethral injections of polyacrylamide hydrogel, commonly used for urinary stress incontinence in non-fistula women, in women with post-fistula closure SUI.
  
  
  METHODS
  Women with urinary incontinence following successful fistula closure were assessed to exclude detrusor overactivity and urinary residual volumes of more than 100 mL. The urethrovesical junction was identified and polyacrylamide hydrogel was injected through the periurethral skin and vaginal epithelium at three sites.
  
  
  RESULTS
  Four women with post-fistula SUI were treated with polyacrylamide hydrogel injections. Three of the four women were dry post-operatively and remained continent at discharge.
  
  
  CONCLUSIONS
  In the short-term, periurethral injections of polyacrylamide hydrogel appears to be a promising method to treat post-obstetric fistula urinary stress incontinence.
authors.affiliation: Greenslopes Private Hospital, Brisbane, Australia; Gynaecology Department, QEII Hospital, Brisbane, Australia; School of Medicine, Griffith University, Gold Coast, Queensland, Australia.
authors.forename: Hannah G
authors.initials: HG
authors.lastname: Krause
authors.forename: Justin P
authors.initials: JP
authors.lastname: Lussy
authors.forename: Judith T W
authors.initials: JT
authors.lastname: Goh
mesh_terms: D000180:Acrylic Resins / Q000008:administration & dosage*; D000328:Adult; D005260:Female; D006801:Humans; D020100:Hydrogels / Q000008:administration & dosage*; D007267:Injections; D008875:Middle Aged; D014521:Urethra; D014550:Urinary Incontinence, Stress / Q000188:drug therapy*; D014719:Vesicovaginal Fistula / Q000628:therapy*; D055815:Young Adult; D000099166:Polyacrylamides
chemical_list: D000180:Acrylic Resins; D020100:Hydrogels; D000099166:Polyacrylamides
keywords: bulking agent; obstetric fistula; urinary incontinence