Patient Characteristics that May Influence the Effect of Urethral Injection Therapy for Female Stress Urinary...

Area of Science:

• Urology
• Female Pelvic Medicine

Background:

• Urethral injection therapy is a recognized treatment for female stress urinary incontinence (SUI).
• Identifying optimal patient candidates for urethral injection therapy is crucial for maximizing treatment success.
• Previous studies have not definitively established the characteristics of patients most likely to benefit from this therapy.

Purpose of the Study:

• To identify patient characteristics associated with successful outcomes following urethral injection therapy for SUI.
• To determine which demographic or clinical factors predict cure or improvement after urethral bulking procedures.

Main Methods:

• A post hoc analysis of a randomized controlled trial comparing a hydrogel bulking agent (Bulkamid®) with a collagen gel (Contigen®).
• Inclusion criteria involved 291 women from an initial randomization of 345 participants.
• Success was defined as cure (no SUI episodes) or improvement (≥50% reduction in SUI episodes) at 1 year post-treatment, assessed via bladder diary and ICIQ-UI-SF.

Main Results:

• Overall, 74 women (25%) were cured, 164 (56%) improved, and 53 (18%) showed no effect at 1 year.
• Multivariate logistic regression identified age ≥60 years and <2.5 daily SUI episodes as predictors of cure.
• Women aged ≥60 with <2.5 daily SUI episodes had a 90% treatment effect and 38% cure rate, versus 13% cure in younger women with ≥2.5 daily episodes.

Conclusions:

• Urethral injection therapy demonstrates significantly higher efficacy in treating female SUI in older women (≥60 years) with less frequent daily symptoms (<2.5 episodes).
• These findings suggest patient selection based on age and symptom frequency can optimize outcomes for urethral bulking procedures.