COLLAGEN INJECTIONS FOR TREATMENT OF URINARY-INCONTINENCE SECONDARY TO INTRINSIC SPHINCTER DEFICIENCY

The injection of glutaraldehyde cross-linked collagen (Contigen(R)) is a recently approved method for treating patients with urinary inconti nence secondary to intrinsic sphincter deficiency (ISD). Forty-five pa tients 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 incon tinence was radical retropubic prostatectomy (RP) in 22, neurogenic bl adder (NB) in 11, and Type III female stress urinary incontinence (FIS D) in 12 individuals. The whole group underwent an average of 1.76 tre atment sessions (range 1-4), and a mean collagen injection volume of 1 2.26 cc (range 5-27.5 cc) was delivered per session. There were no pos toperative complications. Six patients achieved total continence, 28 w ere still incontinent but improved, 9 experienced no change, while 2 d eveloped worsening incontinence. Further analysis indicated that male patients with ISD as a result of RP may achieve some degree of improve ment, but the chances for eradicating incontinence are minimal, wherea s female patients with FISD and individuals with ISD secondary to NE s ignificantly benefit from collagen injection therapy. Longer follow-up is needed to determine the durability of these encouraging results.