de Vries Allert M, van Breda Hendrikje M K, Fernandes Jimmy G, Venema Pieter L, Heesakkers John P F A
Department of Urology, Radboud University Medical Centre, Nijmegen, The Netherlands.
Urol Int. 2017;99(1):91-97. doi: 10.1159/000452450. Epub 2017 Feb 3.
Female stress urinary incontinence (SUI) is often treated surgically. Urethral bulking agents are a minimally invasive alternative, especially in patients suffering from intrinsic sphincter deficiency, but often with limited long-term efficacy. Urolastic® is a non-deformable, non-resorbable silicone elastomer that is used as an injectable. Its properties might result in a more durable response after injection. If this durability factor can be combined with a low complication rate, this can become a useful treatment option. We therefore assessed the subjective improvement and safety after treatment with Urolastic®.
In 2 Dutch hospitals, 65 patients were treated with Urolastic®. The subjective improvement was assessed and the medical charts were reviewed for complications that appeared during the follow-up period. The complications were classified using the Clavien-Dindo classification.
We found that 76-88% of the patients showed subjective improvement at 12-25 months follow-up. The rate of improvement experienced was 50-70%. The rate of complications classified as Clavien-Dindo >II was 24-33%. The 12 patients with 75-100% subjective improvement after 2 months, showed 85% improvement after a median of 25 months.
With careful patient selection, Urolastic® seems to be a safe, durable and effective treatment option for female SUI.
女性压力性尿失禁（SUI）通常采用手术治疗。尿道填充剂是一种微创替代方法，尤其适用于患有内在括约肌缺陷的患者，但长期疗效往往有限。Urolastic®是一种不可变形、不可吸收的硅酮弹性体，用作注射剂。其特性可能导致注射后反应更持久。如果这种持久性因素能与低并发症发生率相结合，那么它可能成为一种有用的治疗选择。因此，我们评估了使用Urolastic®治疗后的主观改善情况和安全性。
在荷兰的两家医院，65例患者接受了Urolastic®治疗。评估主观改善情况，并查阅病历以了解随访期间出现的并发症。使用Clavien-Dindo分类法对并发症进行分类。
我们发现，76% - 88%的患者在12 - 25个月的随访中显示出主观改善。改善率为50% - 70%。Clavien-Dindo分级>II级的并发症发生率为24% - 33%。2个月后主观改善率为75% - 100%的12例患者，在中位25个月后改善率为85%。
经过仔细的患者选择，Urolastic®似乎是女性SUI的一种安全、持久且有效的治疗选择。
