Outcome results of transurethral collagen injection for female stress incontinence

Assessment by urinary incontinence score

Asnat Groutz, Jerry G. Blaivas, Stuart S. Kesler, Jeffrey P. Weiss, David Chaikin

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Purpose: We assessed the results of collagen injection for female sphincteric incontinence using strict subjective and objective criteria. Materials and Methods: We evaluated 63 consecutive women with sphincteric incontinence who underwent a total of 131 transurethral collagen injections. Sphincteric incontinence was confirmed by urodynamics. All patients were treated with 1 to 5 transurethral collagen injections and treatment outcome was classified according to a new outcome score. Cure was defined as no urinary loss due to urge or stress incontinence documented by a 24-hour diary and pad test, and patient assessment that cure was achieved. Failure was defined as poor objective results and patient assessment that treatment failed. Cases that did not fulfill these cure and failure criteria were considered improved and further classified as a good, fair or poor response. Results: Mean patient age plus or minus standard deviation was 67.7 ± 12.8 years. All women had a long history of severe stress urinary incontinence, 18 (29%) underwent previous anti-incontinence surgery, and 41% had combined stress and urge incontinence. Preoperatively diary and pad tests revealed a mean of 7.5 ± 4.6 incontinence episodes and 152 ± 172 gm. of urine lost per 24 hours. Overall 1 to 5 injections were given in 26, 17, 13, 3 and 4 patients, respectively. Mean interval between injections was 4.4 ± 5.7 months, mean followup was 12 ± 9.6 months, and mean interval between the final injection and outcome assessment was 6.4 ± 4.9 months. There was a statistically significant decrease in the total number of incontinence episodes per 24-hour voiding diary after each injection session. Although there was a clear trend toward decreased urinary loss per 24-hour pad test, statistical significance was not established. Using the strict criteria of our outcome score overall 13% of procedures were classified as cure, 10%, 17% and 42% as good, fair and poor, respectively, and 18% as failure. Conclusions: As defined by strict subjective and objective criteria, we noted a low short-term cure rate after collagen injection in women with severe sphincteric incontinence. It remains to be determined how patients with less severe incontinence would fare using our outcome assessment instruments.

Original languageEnglish (US)
Pages (from-to)2006-2009
Number of pages4
JournalJournal of Urology
Volume164
Issue number6
DOIs
StatePublished - Jan 1 2000
Externally publishedYes

Fingerprint

Urinary Incontinence
Collagen
Injections
Outcome Assessment (Health Care)
Urge Urinary Incontinence
Stress Urinary Incontinence
Urodynamics
Urine

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Groutz, Asnat ; Blaivas, Jerry G. ; Kesler, Stuart S. ; Weiss, Jeffrey P. ; Chaikin, David. / Outcome results of transurethral collagen injection for female stress incontinence : Assessment by urinary incontinence score. In: Journal of Urology. 2000 ; Vol. 164, No. 6. pp. 2006-2009.
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abstract = "Purpose: We assessed the results of collagen injection for female sphincteric incontinence using strict subjective and objective criteria. Materials and Methods: We evaluated 63 consecutive women with sphincteric incontinence who underwent a total of 131 transurethral collagen injections. Sphincteric incontinence was confirmed by urodynamics. All patients were treated with 1 to 5 transurethral collagen injections and treatment outcome was classified according to a new outcome score. Cure was defined as no urinary loss due to urge or stress incontinence documented by a 24-hour diary and pad test, and patient assessment that cure was achieved. Failure was defined as poor objective results and patient assessment that treatment failed. Cases that did not fulfill these cure and failure criteria were considered improved and further classified as a good, fair or poor response. Results: Mean patient age plus or minus standard deviation was 67.7 ± 12.8 years. All women had a long history of severe stress urinary incontinence, 18 (29{\%}) underwent previous anti-incontinence surgery, and 41{\%} had combined stress and urge incontinence. Preoperatively diary and pad tests revealed a mean of 7.5 ± 4.6 incontinence episodes and 152 ± 172 gm. of urine lost per 24 hours. Overall 1 to 5 injections were given in 26, 17, 13, 3 and 4 patients, respectively. Mean interval between injections was 4.4 ± 5.7 months, mean followup was 12 ± 9.6 months, and mean interval between the final injection and outcome assessment was 6.4 ± 4.9 months. There was a statistically significant decrease in the total number of incontinence episodes per 24-hour voiding diary after each injection session. Although there was a clear trend toward decreased urinary loss per 24-hour pad test, statistical significance was not established. Using the strict criteria of our outcome score overall 13{\%} of procedures were classified as cure, 10{\%}, 17{\%} and 42{\%} as good, fair and poor, respectively, and 18{\%} as failure. Conclusions: As defined by strict subjective and objective criteria, we noted a low short-term cure rate after collagen injection in women with severe sphincteric incontinence. It remains to be determined how patients with less severe incontinence would fare using our outcome assessment instruments.",
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Outcome results of transurethral collagen injection for female stress incontinence : Assessment by urinary incontinence score. / Groutz, Asnat; Blaivas, Jerry G.; Kesler, Stuart S.; Weiss, Jeffrey P.; Chaikin, David.

In: Journal of Urology, Vol. 164, No. 6, 01.01.2000, p. 2006-2009.

Research output: Contribution to journalArticle

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T1 - Outcome results of transurethral collagen injection for female stress incontinence

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AU - Groutz, Asnat

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N2 - Purpose: We assessed the results of collagen injection for female sphincteric incontinence using strict subjective and objective criteria. Materials and Methods: We evaluated 63 consecutive women with sphincteric incontinence who underwent a total of 131 transurethral collagen injections. Sphincteric incontinence was confirmed by urodynamics. All patients were treated with 1 to 5 transurethral collagen injections and treatment outcome was classified according to a new outcome score. Cure was defined as no urinary loss due to urge or stress incontinence documented by a 24-hour diary and pad test, and patient assessment that cure was achieved. Failure was defined as poor objective results and patient assessment that treatment failed. Cases that did not fulfill these cure and failure criteria were considered improved and further classified as a good, fair or poor response. Results: Mean patient age plus or minus standard deviation was 67.7 ± 12.8 years. All women had a long history of severe stress urinary incontinence, 18 (29%) underwent previous anti-incontinence surgery, and 41% had combined stress and urge incontinence. Preoperatively diary and pad tests revealed a mean of 7.5 ± 4.6 incontinence episodes and 152 ± 172 gm. of urine lost per 24 hours. Overall 1 to 5 injections were given in 26, 17, 13, 3 and 4 patients, respectively. Mean interval between injections was 4.4 ± 5.7 months, mean followup was 12 ± 9.6 months, and mean interval between the final injection and outcome assessment was 6.4 ± 4.9 months. There was a statistically significant decrease in the total number of incontinence episodes per 24-hour voiding diary after each injection session. Although there was a clear trend toward decreased urinary loss per 24-hour pad test, statistical significance was not established. Using the strict criteria of our outcome score overall 13% of procedures were classified as cure, 10%, 17% and 42% as good, fair and poor, respectively, and 18% as failure. Conclusions: As defined by strict subjective and objective criteria, we noted a low short-term cure rate after collagen injection in women with severe sphincteric incontinence. It remains to be determined how patients with less severe incontinence would fare using our outcome assessment instruments.

AB - Purpose: We assessed the results of collagen injection for female sphincteric incontinence using strict subjective and objective criteria. Materials and Methods: We evaluated 63 consecutive women with sphincteric incontinence who underwent a total of 131 transurethral collagen injections. Sphincteric incontinence was confirmed by urodynamics. All patients were treated with 1 to 5 transurethral collagen injections and treatment outcome was classified according to a new outcome score. Cure was defined as no urinary loss due to urge or stress incontinence documented by a 24-hour diary and pad test, and patient assessment that cure was achieved. Failure was defined as poor objective results and patient assessment that treatment failed. Cases that did not fulfill these cure and failure criteria were considered improved and further classified as a good, fair or poor response. Results: Mean patient age plus or minus standard deviation was 67.7 ± 12.8 years. All women had a long history of severe stress urinary incontinence, 18 (29%) underwent previous anti-incontinence surgery, and 41% had combined stress and urge incontinence. Preoperatively diary and pad tests revealed a mean of 7.5 ± 4.6 incontinence episodes and 152 ± 172 gm. of urine lost per 24 hours. Overall 1 to 5 injections were given in 26, 17, 13, 3 and 4 patients, respectively. Mean interval between injections was 4.4 ± 5.7 months, mean followup was 12 ± 9.6 months, and mean interval between the final injection and outcome assessment was 6.4 ± 4.9 months. There was a statistically significant decrease in the total number of incontinence episodes per 24-hour voiding diary after each injection session. Although there was a clear trend toward decreased urinary loss per 24-hour pad test, statistical significance was not established. Using the strict criteria of our outcome score overall 13% of procedures were classified as cure, 10%, 17% and 42% as good, fair and poor, respectively, and 18% as failure. Conclusions: As defined by strict subjective and objective criteria, we noted a low short-term cure rate after collagen injection in women with severe sphincteric incontinence. It remains to be determined how patients with less severe incontinence would fare using our outcome assessment instruments.

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