OBJECTIVE: Total urinary incontinence is a debilitating problem for patients following a radical prostatectomy or transurethal resection of the prostate. We herein report on the clinical results of transurethral collagen (Contigen®; C.R. Bard Inc., Covington, GA, USA) injections in 10 male patients with urinary incontinence following a radical prostatectomy (RP) or transurethral resection of the prostate (TURP).MATERIALS AND METHODS: From July 1998 to April 2000, 10 male patients with urinary
incontinence secondary to intrinsic sphincteric deficiency (9 caused by TURP, 1 by RP) underwent transurethral injection of collagen in our hospital. These patients were documented as having sphincteric insufficiency by cystoscopy and urodynamic studies. Four patients had severe urinary incontinence (≧6 pads/day), 1 had moderate urinary incontinence (4-6 pads/day), and 5 have mild urinary incontinence (≦3 pads/day). Circumferential submucosal injection of collagen was performed
endoscopically under topical anesthesia. Prophylactic antibiotics were given for 3 days after the procedure.RESULTS: The mean number of treatments required to achieve the maximal response was 1.6 (range, 1 to 3) and the mean injected volume was 4 (range, 2 to 8) ml. In our patients, 3 mildly and 1 moderately incontinent patients became dry, while 1 severely and 2 mildly incontinent patients decreased the in daily pad use after the procedure. The success rate was 70% at a mean follow-up period of 16.4 months. The long-term successful result was maintained in 5 patients (50%) after a follow-up of 35.4 months.CONCLUSIONS:
Transurethral injection of Contigen® is an effective and less-invasive
method for selective patients with urinary incontinence caused by sphincteric deficiency.