Long-term results after antegrade collagen injection for stress urinary incontinence following radical retropubic prostatectomy

Objectives. To evaluate the long-term success of antegrade collagen injecti on in men with stress urinary incontinence after radical prostatectomy. Methods. Between October 1994 and January 1996, 20 patients underwent anteg rade collagen injection for stress urinary incontinence caused by radical p rostatectomy. Evaluation by pad test, urodynamics, and subjective scores wa s performed before and after injection. Results. At a mean follow-up of 28 months, 10% of the patients were cured a nd 35% were improved. All patients received a single treatment (mean total volume of collagen injected 14.5 mL). In 11 patients without long-term impr ovement, 2 had undergone irradiation previously and 7 had failed retrograde collagen injections. Two patients with vesical neck contracture were succe ssfully treated. Preoperative incontinence severity and stress leak point p ressure did not correlate with failure. Conclusions. A 45% cured or improved rate at long-term follow-up is possibl e in men with stress incontinence after radical prostatectomy using a singl e antegrade collagen injection. Although antegrade delivery of collagen for stress incontinence minimized short-term, technique-related failures, for a substantial number of patients therapy had failed at long-term follow-up. UROLOGY 53: 974-977, 1999. (C) 1999, Elsevier Science Inc. All rights rese rved.