E. Barranger et al., Results of transurethral injection of silicone micro-implants for females with intrinsic sphincter deficiency, J UROL, 164(5), 2000, pp. 1619-1622
Purpose: We evaluated the medium term efficiency of silicone micro-implants
injected in women with intrinsic sphincter deficiency.
Materials and Methods: A total of 21 women with intrinsic sphincter deficie
ncy underwent transurethral injection of silicone micro-implants between Au
gust 1996 and February 1997. Each patient was assessed preoperatively by qu
estionnaire, physical examination and urodynamic study. The results were ev
aluated by questionnaire at 1 month, and 1 and 2 years after silicone injec
tion. The outcome was classified as dry in all circumstances, improved or f
ailure.
Results: All patients (median age 68 years, range 46 to 83) had undergone p
revious anti-incontinence or prolapse surgeries. At 1 month 2 patients (10%
) were dry and 9 (42%) were improved, and treatment failed in 10 (48%). At
1 year (median 16 months, range 14 to 22) 2 cases (10%) were classified as
dry, 8 (38%) improved and 11 (52%) failures. At last followup (median 31 mo
nths, range 24 to 34) 4 cases (19%) were classified as dry, 6 (29%) improve
d and 11 (52%) failures. None of the 6 patients with bladder neck hypermobi
lity was dry.
Conclusions: Our results of silicone transurethral injection are disappoint
ing but comparable to other bulking agents without a time dependent decreas
e in efficiency. The use of silicone micro-implants is an alternative for t
he treatment of intrinsic sphincter deficiency in patients without bladder
neck hypermobility and in whom the sling procedure has failed.