Nataluk E A, Assimos D G, Kroovand R L
Department of Urology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC, USA.
J Endourol. 1995 Oct;9(5):403-6. doi: 10.1089/end.1995.9.403.
The injection of glutaraldehyde cross-linked collagen (Contigen) is a recently approved method for treating patients with urinary incontinence secondary to intrinsic sphincter deficiency (ISD). Forty-five patients with ISD, 33 males and 12 females, with a mean age of 60 years (range 5-87 years) have been treated with collagen at our institution since its Food and Drug Administration approval. The etiology of incontinence was radical retropubic prostatectomy (RP) in 22, neurogenic bladder (NB) in 11, and Type III female stress urinary incontinence (FISD) in 12 individuals. The whole group underwent an average of 1.76 treatment sessions (range 1-4), and a mean collagen injection volume of 12.26 cc (range 5-27.5 cc) was delivered per session. There were no postoperative complications. Six patients achieved total continence, 28 were still incontinent but improved, 9 experienced no change, while 2 developed worsening incontinence. Further analysis indicated that male patients with ISD as a result of RP may achieve some degree of improvement, but the chances for eradicating incontinence are minimal, whereas female patients with FISD and individuals with ISD secondary to NB significantly benefit from collagen injection therapy. Longer follow-up is needed to determine the durability of these encouraging results.
注射戊二醛交联胶原蛋白（Contigen）是最近批准的一种治疗因内在括约肌缺陷（ISD）导致尿失禁患者的方法。自美国食品药品监督管理局批准以来，我们机构已用胶原蛋白治疗了45例ISD患者，其中男性33例，女性12例，平均年龄60岁（范围5 - 87岁）。尿失禁的病因包括22例根治性耻骨后前列腺切除术（RP）、11例神经源性膀胱（NB）以及12例III型女性压力性尿失禁（FISD）。整个组平均接受了1.76次治疗（范围1 - 4次），每次治疗平均注射胶原蛋白量为12.26立方厘米（范围5 - 27.5立方厘米）。术后无并发症。6例患者实现完全控尿，28例仍有尿失禁但症状改善，9例无变化，2例尿失禁加重。进一步分析表明，因RP导致ISD的男性患者可能有一定程度的改善，但根除尿失禁的机会极小，而患有FISD的女性患者以及因NB导致ISD的患者从胶原蛋白注射治疗中显著获益。需要更长时间的随访来确定这些令人鼓舞的结果的持久性。
