COLLAGEN INJECTIONS FOR INTRINSIC SPHINCTER DEFICIENCY IN THE NEUROPATHIC URETHRA

Twelve subjects experiencing stress urinary incontinence caused by spi nal injury or myelomeningocele were treated by periurethral injection of a bulking agent, glutaraldehyde cross-linked (GAX) collagen. Of the 11 subjects who completed the program, seven were either cured or imp roved and four were only slightly improved or no better following inje ction. The valsalva (abdominal) leak point pressure (LPP) rose an aver age of 57 cm H2O (pre-treatment mean of 60 cm H2O versus post-treatmen t mean of 117 cm H2O) and none of the patients experienced significant complications during the mean follow-up period of 24 months. Every su bject injected was able to maintain an intermittent catheterization pr ogram after treatment. These data support the use of GAX collagen as a n alternative or adjunct therapy to pharmacotherapy, surgical reconstr uction or implantation of a prosthesis in the management of stress uri nary incontinence in the neuropathic urethra.