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Collagen injection therapy for urinary incontinence

R A Appell1

  • 1Department of Urology, Cleveland Clinic Foundation, Ohio.

The Urologic Clinics of North America
|February 1, 1994
PubMed
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Periurethral injections using Contigen offer a safe and effective treatment for intrinsic sphincter deficiency (ISD) incontinence. This minimally invasive procedure benefits carefully selected patients, improving urethral coaptation without obstruction.

Area of Science:

  • Urology
  • Biomaterials Science

Background:

  • Intrinsic sphincter deficiency (ISD) necessitates treatments that promote urethral mucosal coaptation without causing obstruction.
  • Urodynamic goals include increasing leak point pressure while maintaining urethral closure pressure.

Purpose of the Study:

  • To evaluate the efficacy and safety of periurethral injections with Contigen for treating urinary incontinence due to ISD.
  • To assess the durability and immunogenicity of cross-linked bovine collagen bulking agents.

Main Methods:

  • A multicenter trial involving patients with ISD treated with periurethral Contigen injections.
  • Long-term follow-up (over 5 years) to monitor adverse events and treatment durability.
  • Assessment of patient selection criteria, including detrusor function, bladder capacity, and urethral hypermobility.

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Main Results:

  • Contigen demonstrated efficacy and safety in appropriately selected patients.
  • Cross-linking of bovine collagen enhanced durability and reduced immunogenic reactions; no adverse immunogenicity events were reported.
  • The injection procedure is technically straightforward, often performed under local anesthesia, making it suitable for patients ineligible for surgery.

Conclusions:

  • Periurethral Contigen injections are a valuable treatment option for ISD-related incontinence, particularly for patients unsuitable for surgical interventions.
  • Careful patient selection is crucial for optimal outcomes, favoring those without detrusor issues, with adequate bladder capacity, and minimal urethral hypermobility.
  • Contigen serves as an important adjunct in managing adult and pediatric incontinence.