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Collagen injection therapy for post-prostatectomy incontinence

D N Smith1, R A Appell, R R Rackley

  • 1Department of Urology, The Cleveland Clinic Foundation, Ohio 44195, USA.

The Journal of Urology
|July 29, 1998
PubMed
Summary

Transurethral collagen injections offer a viable treatment for post-prostatectomy incontinence, with nearly 40% achieving social continence. Success is less likely for patients with prior clamp use or bladder neck contracture treatment.

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Urethral Bulking Agents

Background:

  • Post-prostatectomy incontinence affects 5-12% of men, significantly impacting quality of life.
  • Renewed interest in injectable urethral bulking agents follows the approval of glutaraldehyde cross-linked collagen.

Purpose of the Study:

  • To investigate the long-term efficacy of transurethral collagen injection therapy for post-prostatectomy incontinence.
  • To identify prognostic criteria for successful collagen injection treatment.

Main Methods:

  • 62 men with post-prostatectomy incontinence received transurethral collagen injections.
  • Median follow-up was 29 months post-injection.

Main Results:

  • 38.7% of patients achieved social continence (dry or minimal leakage with 1 pad/day).

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  • 8.1% achieved total dryness.
  • Success rates varied: 35.2% for radical prostatectomy vs. 62.5% for transurethral resection of the prostate patients.

    • Conclusions:

    • Transurethral collagen injection is a reasonable option for select patients with failed conservative therapies.
    • Poor responders include those requiring penile clamps, experiencing continuous leakage, or with prior bladder neck incision.