Kieswetter H, Fischer M, Wöber L, Flamm J
Department of Urology, Wilhelminen Hospital, Vienna, Austria.
Br J Urol. 1992 Jan;69(1):22-5. doi: 10.1111/j.1464-410x.1992.tb15451.x.
Sixteen women whose ages ranged from 42 to 73 years (mean 57) and 2 men, aged 76 and 80 years respectively, were treated for urinary stress incontinence with transurethral implantation of submucosal glutaraldehyde cross-linked collagen (GAX); 15 females had had several continence operations previously and 1 female was totally incontinent following low anterior resection of the sigmoid colon for cancer. All but 2 patients received 8 ml GAX in a single operative session under general anaesthesia. Before implantation, patients underwent urodynamic evaluation, cystoscopy, urinary stress test and the two-thirds capacity pad weighing test. Post-operative evaluations were carried out after 3, 6 and 9 months and included urinary flow rate, urine analysis, residual urine determination and the two-thirds pad weighing test. The results were encouraging. After 3 months, 8/18 patients were cured, 7/18 had improved and 3/18 had failed to respond. Nine months post-operatively, 7 patients were still continent, 8 had improved and 3 remained unchanged. One of the improved group had a reinjection 18 months post-operatively and has been continent since then. We feel that GAX collagen injection is a safe and easy method for the treatment of urinary stress incontinence; it has no observable or measurable morbidity.
