ENDOSCOPIC INJECTION OF GLUTARALDEHYDE CROSS-LINKED COLLAGEN FOR EFFERENT LIMB INCOMPETENCE IN THE INDIANA RESERVOIR

Purpose: We determined the clinical applicability, safety and efficacy of endoscopically injected glutaraldehyde cross-linked collagen for t he treatment of efferent limb incompetence in the incontinent Indiana urinary reservoir. Materials and Methods: Six patients were diagnosed with incompetence of the efferent limb of the Indiana reservoir by vid eo urodynamics. Glutaraldehyde cross-linked collagen was injected thro ugh the efferent limb at the level of the ileocecal valve. Outcome was assessed by evaluation of dryness and pouchograms.Results: With a mea n followup time of 26 months (range 6 to 36) after the last injection 5 of the 6 patients were cured. The remaining patient, although improv ed, had a small capacity and subsequently underwent ileal patch augmen tation. No patient failed to improve. The mean volume of collagen was 16 ml. (range, 5 to 26). Reservoir volume increased from 150 to 400 ml . Conclusions: The use of glutaraldehyde cross-linked collagen in the treatment of the incontinent Indiana reservoir is safe and effective.