title: Durability of collagen injection for stress urinary incontinence in women proven by transvaginal 3-dimensional ultrasound.
abstract: OBJECTIVE
  The aim of this study is to evaluate the durability of collagen injection (CI) using serial 3-dimensional (3D) transvaginal ultrasound (US) in women with sufficient improvement of stress urinary incontinence (SUI) symptoms not requiring additional treatment.
  
  
  METHODS
  After the institutional review board approval, a retrospective review of prospectively followed patients who underwent CI was conducted. Eligible patients received 3 or less consecutive CI for SUI with no reinjection afterward during the follow-up period and had a minimum follow-up of 1 year from the last CI. Serial 3D US was obtained for collagen volume and configuration at baseline (6-8 weeks postoperatively) and approximately every 12 months thereafter as clinically indicated.
  
  
  RESULTS
  Of 191 eligible patients from 1/99 to 6/11, 67 (35%) met the inclusion criteria. The mean age was 67 years (42-90 years) with mean follow-up from the time of last CI at 43 months (12-149 months). A total of 283 three-dimensional US were performed, with the mean of 4 (2-11) per patient. The mean number of injections was 1.4 (1-3) with a mean injected volume at 5.8 mL (2-18 mL). The volume retention rate compared with the baseline volume was 84% (12%-100%), with a decrease in mean collagen volumes between the baseline and last follow-up visit (3.2 vs 2.7 mL; P = 0.008). Collagen volume decreased by a mean of 0.11 mL for each year past the final injection (P = 0.0015) by mixed-effect model analysis.
  
  
  CONCLUSIONS
  Although believed to be nondurable, CI was found to be objectively stable over time by transvaginal 3D US in a subset of women with durably improved SUI symptoms.
authors.affiliation: From the UT Southwestern Medical Center, Dallas, TX.
authors.forename: Chasta-Dawne L
authors.initials: CD
authors.lastname: Bacsu
authors.forename: Caitlin
authors.initials: C
authors.lastname: Cunningham
authors.forename: Alana
authors.initials: A
authors.lastname: Christie
authors.forename: Philippe E
authors.initials: PE
authors.lastname: Zimmern
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003094:Collagen / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D007267:Injections; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D014463:Ultrasonography; D014521:Urethra / Q000000981:diagnostic imaging*; D014550:Urinary Incontinence, Stress / Q000000981:diagnostic imaging / Q000628:therapy*
chemical_list: D003094:Collagen