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[The injectables in urogynecology]
P Pifarotti1, U Gattei, M Meschia
1Servizio di Uroginecologia, Dipartimento di Ostetricia e Ginecologia, Clinica L. Mangiagalli, Università degli Studi di Milano, Milan, Italy. uroginecologia@infinito.it
Minerva Ginecologica
|April 25, 2003
Summary
Injectable agents offer treatment options for female stress urinary incontinence, particularly intrinsic sphincter deficiency. While some agents show promise, long-term effectiveness and safety require further investigation.
Area of Science:
- Urology
- Minimally Invasive Surgery
Context:
- Female stress urinary incontinence (SUI) affects many women.
- Injectable agents are a minimally invasive treatment option for SUI.
- Intrinsic sphincter deficiency (ISD) is a primary indication for injectables.
Purpose:
- To review and summarize the efficacy and safety of various injectable agents for treating female SUI.
- To compare the outcomes of different injectable materials, including Teflon, autologous fat, collagen, silicone microparticles, silicone microballoons, and pyrolytic carbon.
Summary:
- Collagen showed initial high success rates (60-80%) but decreased over time.
- Teflon has limited acceptance due to low success rates and complications like particle migration.
- Silicone microparticles demonstrated a ~70% long-term success rate in ISD patients and offer easier administration.
- Newer agents like silicone microballoons and pyrolytic carbon show ~70% short-term success, but require longer follow-up.
Impact:
- Injectable agents provide alternatives for SUI management, with silicone microparticles showing durable results in ISD.
- Further clinical trials are necessary to establish long-term durability, cost-effectiveness, and safety profiles of these agents.