Periurethral collagen injections: 2-year results in 25 women with severe urinary incontinence.

Objectives. To study the efficacy and safety of periurethral collagen injec tion in the treatment of severe urinary incontinence. Patients and Methods: From 1994 to 1998, 25 periurethral collagen injection s were performed in 25 women with a mean age of 65 years presenting with ur inary incontinence classified as grade III in 17 cases and grade II in 9 ca ses, under local anaesthesia in 5 cases, spinal anaesthesia in 10 cases and general anaesthesia in 10 cases, Twenty patients were treated for recurren t incontinence. One injection was performed in 20 cases and two injections were performed in 5 cases. None of the patients presented disorders of pelv ic muscles. The preoperative urodynamic assessment did not reveal any cases of detrusor instability, and showed a mean urethral closure pressure of 35 cm H2O. A skin test was performed in each case ah least 30 days before the injection. Results: The mean hospital stay was 2.75 days. The mean quantity of collage n injected was 5.7 ml. With a mean follow-up of 24 months, 33% of patients were continent, 39% were improved and 28% were considered to be failures. N o complications were observed. Conclusion: Due to its safety, this method can be proposed in outpatients w ith good results, in patients of all ages, either as first-line treatment o r for recurrent incontinence, as, in the case of failure, this technique do es not comprise subsequent treatment by another operation.