TRANSURETHRAL INJECTION OF SILICONE MICROIMPLANTS FOR INTRINSIC URETHRAL SPHINCTER DEFICIENCY

Objective: To assess the short-term efficacy of transurethral injectio n of silicone microimplants in women with intrinsic sphincter deficien cy. Methods: During January 1995 and December 1996, 32 women (mean age 64.3 years, range 39-85 years) with type III stress incontinence (int rinsic sphincter deficiency) underwent transurethral injection of sili cone microimplants under general anesthesia. Twenty-eight had undergon e previous continence surgery. Subjective and urodynamic assessments w ere made at 6 and 12 months after injection to evaluate success and sh ort-term effects. Results: Objective and subjective success rates were 75% and 59% at 6 and 12 months, respectively. Injections of silicone microimplants significantly increased maximum urethral closure pressur e (maximum urethral pressure at rest: 34.40 +/- 16.46 cm H2O, 95% conf idence interval [CI] 28.55, 40.25 versus 25.35 +/- 10.78 cm H2O, 95% C I 21.52, 29.18; P = .027). There were no complications after surgery u p to 1 year. Conclusion: Transurethral silicone injections were effect ive in 60% of cases of intrinsic sphincter deficiency, although there was a time-dependent decrease. (Obstet Gynecol 1998;92:332-6. (C) 1998 by The American College of Obstetricians and Gynecologists.).