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Urethral prolapse after collagen injection
R L Harris1, G W Cundiff, K W Coates
1Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina, USA.
American Journal of Obstetrics and Gynecology
|April 16, 1998
Summary
Periurethral injection of glutaraldehyde cross-linked collagen for urinary incontinence can cause urethral prolapse. This rare complication required surgical intervention, highlighting a potential risk of the collagen injection procedure.
Area of Science:
- Urology
- Biomaterials Science
Background:
- Intrinsic urethral sphincteric deficiency (IUSD) is a common cause of stress urinary incontinence.
- Periurethral bulking agents, such as glutaraldehyde cross-linked collagen (e.g., Contigen), have been used to treat IUSD.
Observation:
- A patient treated with glutaraldehyde cross-linked collagen for IUSD developed urethral mucosal prolapse.
- The prolapse led to a recurrence of urinary incontinence.
Findings:
- This case represents the first reported instance of urethral mucosal prolapse as a complication following glutaraldehyde cross-linked collagen injection.
- The patient required subsequent surgical management, including resection and a fascia lata sling, to address the complication.
Implications:
- This finding suggests a rare but serious potential complication associated with glutaraldehyde cross-linked collagen injections for IUSD.
- Clinicians should be aware of this risk and consider alternative treatments or careful patient selection.
- Further research may be needed to understand the mechanism and incidence of this complication.