Madjar Shahar, Sharma Anoop K, Waltzer Wayne C, Frischer Zelik, Secrest Charles L
Department of Urology, State University of New York at Stony Brook, Stony Brook, New York, USA.
J Urol. 2006 Apr;175(4):1408-10. doi: 10.1016/S0022-5347(05)00679-8.
Durasphere is gaining popularity as a bulking agent for treating women with stress urinary incontinence. We present a series of patients with periurethral mass formation following Durasphere injection.
The charts of 135 women with a mean age of 69.4 years (range 46 to 83) who underwent Durasphere periurethral injections were retrospectively reviewed. Patients who had a periurethral mass were identified and their clinical data were collected and analyzed.
Four patients (2.9%) were diagnosed with periurethral mass formation 12 to 18 months (average 14.7) following a Durasphere injection. Clinical presentation varied, including irritative voiding symptoms, pelvic pain and urinary incontinence. All patients were found to have a tender and tense periurethral mass. A radiopaque mass was revealed during videourodynamic study in 1 patient. Incision, and transvaginal and endoscopic drainage or transvaginal excision were used to treat these masses. Intraoperative and pathological findings as well as operative outcomes are presented.
Irritative or obstructing voiding symptoms, pelvic pain or a periurethral mass in patients with a history of Durasphere or other periurethral bulking agent injection should alert the physician to the possibility of periurethral mass formation. The true incidence of this late complication remains to be determined.
Durasphere作为一种用于治疗女性压力性尿失禁的填充剂正越来越受欢迎。我们报告了一系列在注射Durasphere后出现尿道周围肿块形成的患者。
回顾性分析135例平均年龄69.4岁（范围46至83岁）接受Durasphere尿道周围注射的女性患者的病历。确定有尿道周围肿块的患者，并收集和分析其临床资料。
4例患者（2.9%）在注射Durasphere后12至18个月（平均14.7个月）被诊断为尿道周围肿块形成。临床表现各异，包括刺激性排尿症状、盆腔疼痛和尿失禁。所有患者均发现有压痛且质地紧张的尿道周围肿块。1例患者在视频尿动力学检查中发现不透X线的肿块。采用切开、经阴道和内镜引流或经阴道切除来治疗这些肿块。展示了术中及病理检查结果以及手术效果。
有Durasphere或其他尿道周围填充剂注射史的患者出现刺激性或梗阻性排尿症状、盆腔疼痛或尿道周围肿块，应提醒医生注意尿道周围肿块形成的可能性。这种晚期并发症的真实发生率仍有待确定。
