Endoscopic Treatment of Urinary Incontinence: Long-Term Evaluation of the Results

Guys, Jean-Michel; Fakhro, Abdulla; Louis-Borrione, C.; Prost, J F; HAUTIER, A.

doi:10.1016/s0022-5347(05)66211-8

Cited by 35 publications

(16 citation statements)

References 19 publications

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“…25 Thus, endoscopic injection of 23,25 In all patients there was no evidence of local or systemic allergic reactions or of particle migration. This is because local reaction to PDS consists of the recruitment of monocytes which are transformed into giant cells and subsequently encapsulated by fibroblasts, thus forming a three-dimensional matrix without tissue necrosis.…”

Section: Discussionmentioning

confidence: 85%

The treatment of male stress urinary incontinence with polydimethylsiloxane in compliant bladders following spinal cord injury

Hamid

Arya²,

Khastgir

et al. 2003

Spinal Cord

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Study design: Retrospective analysis. Objectives: To evaluate the safety and efficacy of polydimethylsiloxane (PDS, Macroplastiquet) submucosal injections, in the treatment of male genuine stress urinary incontinence secondary to spinal cord injury (SCI). Setting: London Spinal Injuries Unit, Stanmore, UK and Institute of Urology and Nephrology, London, UK. Patients and methods: A retrospective analysis identified 14 patients treated with PDS for stress urinary incontinence secondary to SCI between 1997 and 2001. A single surgeon at a specialist spinal injuries unit managed all patients. A total of 13 patients had suffered a traumatic SCI (T11:n ¼ 2; T12:n ¼ 5; L1:n ¼ 5; L2:n ¼ 1), while one developed stress incontinence after spinal surgery. The mean age was 41 years (range 26-69 years) and the mean duration of injury was 9.6 years (range 1.5-48 years). The preoperative investigations included video cystometrogram (VCMG) confirming the presence of urodynamically proven stress incontinence without evidence of urge incontinence. Complete cure was defined as a cessation of pad usage with no evidence of leakage on VCMG. Incomplete cure with improvement was defined as a 450% reduction in the number of pads used, with incontinence present on VCMG. Results: The follow-up ranged from 12 to 58 months (mean 34.7 months). Five patients (36%) reported complete success, confirmed by VCMG. Three patients (21%) reported improvement with 450% reduction in the use of pads. The procedure failed completely in six patients (43%). No immediate or late complications were noted with the procedure. Conclusions: The use of PDS is a safe and minimally invasive treatment for genuine stress urinary incontinence in males following SCI with a stable compliant bladder. We achieved complete cure in 36% of our patients with confirmation on VCMG. A further 21% reported greater than 50% reduction in usage of pads; however, on VCMG stress incontinence was demonstrated in these patients. We suggest that PDS can be used as the first line of treatment in this difficult group of patients with complex problems.

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Section: Discussionmentioning

confidence: 85%

The treatment of male stress urinary incontinence with polydimethylsiloxane in compliant bladders following spinal cord injury

Hamid

Arya²,

Khastgir

et al. 2003

Spinal Cord

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“…Periurethral injection of bulking materials has proved to be effective to improve urinary incontinence in paediatric patients [5,[10][11][12]. Various injectable materials have been used for this procedure.…”

Section: Discussionmentioning

confidence: 99%

First paediatric experience of a new device for “non-endoscopic” periurethral injection in urinary incontinence

et al. 2005

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The results of endoscopic treatment for urinary incontinence (ETUI) depend on the condition of the urethral mucosa and on the length of the urethra. ETUI is quite difficult to perform in female patients, and, in general, in cases of scarred urethral mucosa. A new device (Zuidex, Q-Med, Uppsala, Sweden) has recently been designed for the "non-endoscopic" treatment of urinary stress incontinence in women. Three paediatric cases are described hereunder. Three patients were treated using Zuidex: two patients (two girls aged 8 and 18) on intermittent catheterization for neurogenic bladder, and one 11-year-old girl, with epispadias, who had already undergone bladder neck reconstruction (Young-Deese). Zuidex is a special implacer for dextranomer implants. It consists of four syringes filled with dextranomer, one implacer, and four needles (25 gauges). Once the device is positioned, the four injections are performed. At the end of this procedure, four implants are symmetrically positioned at four points of the urethral wall, increasing the outlet resistance. In the follow-up phase (5-13 months), the increase in the continent period was +56, 50 and 36%; the increase in bladder capacity (leak volume point) was 40, 28 and 27% in the three patients. Although the new device for "non-endoscopic" treatment of urinary incontinence has been designed for women, the size of the implacer virtually allows its use in any paediatric patient who is above the age of six. Our early experience indicates that this new device could play an important role in the treatment of urinary incontinence in paediatric age.

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“…In males, the needle is inserted submucosally at the level of verumontanum and advanced to the bladder neck [ 13 ]. Recently, injection below the verumontanum is also advocated [ 14 ]. In females, the scope is positioned in the midurethra, and the needle injection occurs submucosally from bladder neck to the midproximal urethra.…”

Section: Retrograde Transurethral Approachmentioning

confidence: 99%

“…Approximately one-third of patients who achieve initial continence with bladder neck injection of bulking agents deteriorate in the fi rst year and become wet [ 14 ]. In 2006, a large series demonstrated success rates of 79 % (48 of 61 patients) at 1 month, 56 % (31 of 55) at 6 months, 52 % (24 of 46) at 1 year, 51 % (18 of 35) at 2 years, 52 % (16 of 31) at 3 years, 48 % (12 of 25) at 4 years, 43 % (9 of 21) at 5 years, 36 % (4 of 11) at 6 years, and 40 % (2 of 5).…”

Section: Complicationsmentioning

confidence: 99%

See 1 more Smart Citation

Bladder Outlet Injection for Urinary Incontinence

Yücel

Baker

2013

Pediatric Endourology Techniques

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Urinary incontinence in children is multifactorial, and thus numerous medical and surgical modalities exist to treat it. In patients with congenital incompetence of the bladder neck/sphincteric mechanism or leak from a continent catheterizable channel, a viable minimally invasive option is cystoscopic-guided injection of bulking agents. In this chapter, indications, surgical techniques, complications, and outcomes of bulking agent injection therapy for urinary incontinence will be discussed. • What is the total quantity of urine produced daily? Does the quantity exceed the capacity of the urinary system? • Is the bladder capable of storing urine? -What is the bladder capacity and detrusor compliance? Is there increased bladder contractility, such as in neurogenic bladder, infection, or detrusor hypertrophy? Keywords

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Endoscopic Treatment of Urinary Incontinence: Long-Term Evaluation of the Results

Cited by 35 publications

References 19 publications

The treatment of male stress urinary incontinence with polydimethylsiloxane in compliant bladders following spinal cord injury

The treatment of male stress urinary incontinence with polydimethylsiloxane in compliant bladders following spinal cord injury

First paediatric experience of a new device for “non-endoscopic” periurethral injection in urinary incontinence

Bladder Outlet Injection for Urinary Incontinence

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