Bladder Outlet Obstruction After Multiple Periurethral Polytetrafluoroethylene Injections

McKinney, Christopher D.; Gaffey, M. J.; Gillenwater, Jay Y.

doi:10.1097/00005392-199501000-00053

Cited by 44 publications

(12 citation statements)

References 19 publications

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“…Historically, the bladder neck used to be the anatomic area to be addressed using surgery for stress incontinence: Burch colposuspension and abdominal sling procedures will lift the bladder neck by elevation of the bladder neck [15,16]. Newer techniques place artificial suburethral slings under the mid-urethra [17] based on the "integral theory" presented by Petros and Ulmsten [18].…”

Section: Introductionmentioning

confidence: 99%

Where should bulking agents for female urodynamic stress incontinence be injected?

et al. 2007

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For bulking agents used for female stress urinary incontinence, the recommendation for the anatomical placement varies as some injectables are to be placed close to the bladder neck and others midurethrally. Aim of the study was to determine if there are differences concerning the outcome after transurethral collagen injections depending on the anatomical placement midurethrally or at the bladder neck. We randomly assigned 30 elderly female patients with urodynamic stress incontinence to either transurethral collagen injection midurethrally or to the bladder neck. Prior to injection and at ten month follow-up, maximum urethral closure pressure (MUCP), functional urethral length (FUL), maximum flow rate and cough test were performed and the patient was asked to estimate her bladder condition using a visual analogue scale. Postoperative contentness was 8 (median, 95% confidence interval 5-9) in the midurethral group and 8 (median, 95% confidence interval 7-10) in the bladder neck group with a p value of 0.012, 95% confidence interval -2.464 to -0.2859, in favour to midurethral injections. MUCP and FUL increased significantly in both groups and flow rate decreased in both groups. Continence was 66.6% in the midurethral group and 60% for the bladder neck group respectively. Both midurethral and bladder neck collagen injections improve patients' satisfaction almost equally with a small advantage for midurethral injections.

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Section: Introductionmentioning

confidence: 99%

Where should bulking agents for female urodynamic stress incontinence be injected?

et al. 2007

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“…This migration results in the formation of foreign body granulomas locally or distally. Locally, urethral fibrosis, diverticulum, and periurethral abscess resulting in bladder outlet obstruction have been reported [9,22]. PTFE has been shown to have varying degrees of clinical effectiveness in the management of SUI.…”

Section: Synthetic Materialsmentioning

confidence: 99%

Use of Injectable Urethral Bulking Agents in the Management of Stress Urinary Incontinence

Taylor

Dielubanza

Hairston

2011

Curr Bladder Dysfunct Rep

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The use of injectable bulking agents is a wellestablished approach to management of patients with stress urinary incontinence (SUI). No single bulking agent to date has been shown to be superior or consistently durable in the literature. Novel therapeutic strategies, including the use of injectable, muscle-derived stem cell therapy, have shown promising results in investigational stages. Urethral bulking agent therapy can be helpful in the early management of men with SUI following radical prostatectomy, and in women with SUI due to intrinsic sphincter deficiency, urethral hypermobility, or in the setting of failed midurethral sling placement. Despite their widespread use historically, biocompatible agents have been supplanted in recent years by synthetic agents secondary to their potentially improved durability and nonimmunogenic profiles.

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“…A further potential postinjection complication is the development of an injection site mass (cyst, sterile abscess). While this has been observed in association with several injectable agents [collagen, polytetrafluoroethylene (PTFE), carbon-coated zirconium beads, and NASHA/Dx gel] [9,[31][32][33], few patients are affected, and after treatment/resolution, there are no direct long-term sequelae.…”

Section: Long-term Safety Profilementioning

confidence: 99%

Patient-perceived outcomes in the treatment of stress urinary incontinence: focus on urethral injection therapy

et al. 2006

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Intervention for stress urinary incontinence (SUI) is generally focused on minimizing urinary leakage. However, the overall impact of SUI therapy on patients' quality of life is, arguably, more important than leakage outcomes. We performed a literature search to investigate the effect of urethral injection therapy on quality of life. Significant quality-of-life improvements have been observed with a number of injectable agents, while there is a distinct lack of correlation between subjective and objective outcomes. Two studies comparing urethral injection therapy with surgical intervention found superior objective efficacy with surgery, but no significant differences in quality-of-life improvements. Personal goals of patients undergoing urethral injection are yet to be explored, but there may be willingness to trade a lower success rate in favor of a more minor treatment procedure. In conclusion, quality-of-life improvements after urethral injection appear significant and comparable to those obtained with surgery. Further study of patients' own perceptions, pre- and posttreatment, would be valuable.

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Bladder Outlet Obstruction After Multiple Periurethral Polytetrafluoroethylene Injections

Cited by 44 publications

References 19 publications

Where should bulking agents for female urodynamic stress incontinence be injected?

Where should bulking agents for female urodynamic stress incontinence be injected?

Use of Injectable Urethral Bulking Agents in the Management of Stress Urinary Incontinence

Patient-perceived outcomes in the treatment of stress urinary incontinence: focus on urethral injection therapy

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