Aboseif S R, O'Connell H E, Usui A, McGuire E J
Department of Urology, University of Texas Medical School, Houston 77030, USA.
J Urol. 1996 Jan;155(1):10-3.
We evaluated the efficacy of collagen injections in the treatment of male urinary incontinence due to intrinsic sphincteric deficiency.
A total of 88 men (mean age 68 years) with mild to severe intrinsic sphincter deficiency underwent a mean of 3.5 transurethral injections of collagen (mean total volume injected 25 ml.). Patients were subdivided into 2 groups based on use of more than 3 or 3 or fewer pads per day. Patient age, pad use before treatment, duration of leakage, number of injections, volume of collagen used and etiology of incontinence were compared for the 2 groups.
Of the patients 42 became nearly completely dry, 19 had substantial improvement but still required 1 to 3 pads per day, 14 consistently used fewer pads but still more than 3 per day and 13 showed no improvement. Most injections were performed with the patient under local anesthesia and no significant morbidity occurred.
In select patients collagen injections appear to be effective, easy to deliver and safe. Pretreatment incontinence severity, concomitant detrusor abnormalities and etiology of intrinsic sphincteric deficiency other than radical retropubic prostatectomy were associated with a worse response to collagen therapy.
我们评估了胶原蛋白注射治疗因内在括约肌缺陷导致的男性尿失禁的疗效。
共有88名男性（平均年龄68岁），存在轻度至重度内在括约肌缺陷，平均接受了3.5次经尿道胶原蛋白注射（平均总注射量25毫升）。根据患者每天使用尿垫数量是否超过3片，将患者分为两组。比较两组患者的年龄、治疗前尿垫使用情况、漏尿持续时间、注射次数、胶原蛋白使用量以及尿失禁病因。
42名患者几乎完全干爽，19名有显著改善，但仍需每天使用1至3片尿垫，14名患者使用的尿垫数量持续减少，但仍超过每天3片，13名患者无改善。大多数注射在局部麻醉下进行，未发生明显并发症。
在特定患者中，胶原蛋白注射似乎有效、操作简便且安全。除耻骨后根治性前列腺切除术后，治疗前尿失禁严重程度、伴发的逼尿肌异常以及内在括约肌缺陷的病因与胶原蛋白治疗反应较差有关。
