Abstract
We correlated preoperative urodynamic and intraoperative endoscopic findings with initial improvement, single collagen injection effectiveness for intrinsic sphincter deficiency (ISD), and long-term improvement following transurethral collagen injection for stress urinary incontinence (SUI). Since 1993, 79 patients have been treated with transurethral collagen injection by the same urologist. Of these patients, intraoperative photographs of urothelial coaptation immediately after injection were available in 67 patients: 35 women with ISD, 24 men with incontinence, primarily following prostatectomy, and 8 children with neurogenic bladder. Urothelial coaptation was described as snug, fair, or poor. Preoperative Valsalva leak point pressure (VLPP), detrusor instability, impaired bladder compliance, bladder neck appearance, urothelial scarring, and degree of coaptation were correlated with both initial and long-term improvement. Initial improvement was compared with long-term improvement. Initial improvement was experienced by 85% of all the subjects (86%) of the women, 80% of the men, and 100% of the children with a neurogenic bladder condition). Overall, 31% of patients had long-term improvement after a mean follow-up of 2.2 year...Continue Reading
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