Long-term outcome of transurethral injection of hyaluronic acid/dextranomer (NASHA/Dx gel) for the treatment of stress urinary incontinence (SUI)

Lone, Farah; Sultan, Abdul H.; Thakar, Ranee

doi:10.1007/s00192-010-1211-4

Cited by 9 publications

(9 citation statements)

References 26 publications

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“…The findings are in good agreement with a study by Ghoniem et al that showed 88 % durability success and few complications after 2 years [27]. In contrast, two studies on transurethral injection of hyaluronic acid/dextranomer (NASHA/Dx gel) showed poor durability of effect and a high incidence of complications [28, 29]. …”

Section: Discussionsupporting

confidence: 89%

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Two-year follow-up of an open-label multicenter study of polyacrylamide hydrogel (Bulkamid®) for female stress and stress-predominant mixed incontinence

et al. 2012

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Introduction and hypothesisPolyacrylamide hydrogel (PAHG, Bulkamid®) is a promising urethral bulking agent. This article presents the 2-year follow-up results of a multicenter study of PAHG injections for treating stress and stress-predominant mixed urinary incontinence.MethodsSubmucosal injection of PAHG was performed in 135 women with urinary incontinence, with subjective and objective assessment of the efficacy and safety 24 months postinjection.ResultsAt 24 months, the subjective responder rate was 64 % (a statistically non-significant reduction from 67 % at 12 months). The decreased number of incontinence episodes and urine leakage were maintained compared with the result from the 12-month evaluations, as were objective result rates and quality of life data. No safety issues occurred.ConclusionsPAHG is an effective and safe treatment option for women with stress-predominant mixed urinary incontinence, with maintained medium-term responder rates.

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Section: Discussionsupporting

confidence: 89%

“…Safety concerns have been raised regarding specific bulking agents because of migration, hypersensitivity, urethral erosion, pseudocysts/abscess, granuloma formation, and obstruction [3–9, 28, 29]. All AEs recorded after PAHG injection were generic and not related to the material.…”

Section: Discussionmentioning

confidence: 99%

Two-year follow-up of an open-label multicenter study of polyacrylamide hydrogel (Bulkamid®) for female stress and stress-predominant mixed incontinence

et al. 2012

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“…Injection of a periurethral bulking agent has also been associated with acceptably low rates of local complications, including transient hematuria, urinary retention, and irritative symptoms 28 . The limitation of current bulking agents is their lack of permanent durability, with the cure rate decreasing significantly over time, to about 30% at long‐term follow‐up 29–31 …”

Section: Surgical Management Of Failed Musmentioning

confidence: 99%

Management of Recurrent or Persistent Stress Urinary Incontinence after Mid‐urethral Sling

Han

Lee

Choo

2012

LUTS

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The mid-urethral sling (MUS) procedure is the most common treatment modality for women with stress urinary incontinence (SUI). Although this procedure is highly successful, 5-20% of patients undergoing MUS experience persistent or recurrent SUI, regarded as surgical failure. However, little is known about methods to evaluate and manage patients who fail MUS procedures. The surgical options in these patients include bulking agent injection, shortening of pre-implanted tape, pubovaginal sling and repeat MUS. Of these secondary procedures, repeat MUS is the most widely studied, although this has been limited to small case series without long-term follow-up. Repeat MUS for prior MUS failure has shown relatively good success rates, ranging from 55 to 90%, with better outcomes obtained using the retropubic rather than the transobturator route. Persistent or recurrent SUI may also be successfully managed with less invasive techniques, such as tape shortening and periurethral injection of a bulking agent. Transurethral injection therapy for primary SUI has shown success rates of more than 65% at 1 year; however, these decreased significantly thereafter to around 30% at long-term follow-up. Since the optimal management of recurrent or persistent SUI after MUS has not yet been established, long-term, prospective, randomized trials are warranted.

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“…[1][2][3] New clinical applications are gaining interest, such as the use of soft tissue fillers for treating nonfacial areas, including glans penis augmentation, recurrent tracheoesophageal fistula, fecal incontinence, and stress urinary incontinence. [4][5][6][7] An ideal injectable soft tissue filler should guarantee safety including good biocompatibility, minimal risks of infection and rejection, risk of diffusion, lack of migration, and no carcinogenic potential. It should also be easily administered, long lasting, and inexpensive.…”

Section: Introductionmentioning

confidence: 99%

Effects of crosslinked dextran in hydroxylpropyl methylcellulose on soft tissue augmentation in rats

et al. 2013

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This study compared crosslinked dextrans in hydroxylpropyl methycellulose (DiHMs, pH 5 or 7) with polymethylmethacrylate in bovine collagen (PMMA) and hyaluronic acid (HA) fillers on soft tissue augmentation and safety in rats. HA tended to maintain its size throughout the experimental period but was moveable and friable because of a lack of thick fibroconnective tissue formation. Although, PMMA induced moderately thick fibroconnective tissue formation, its size was decreased markedly from 3-week postimplantation (PI) and became the smallest at 24-month PI. DiHM (pH 7) elicited strong fibrous encapsulation around the filler. Its size decreased slowly but was still considerably maintained at 24-month PI. In contrast, the rate of the DiHM (pH 5) size decrease was slower than that of PMMA, faster DiHM (pH 7), but comparable to HA. Immunohistochemically, types I and III collagens were deposited inside and outside DiHMs (pH 5 and 7). DiHMs (pH 5 and 7), PMMA, and HA showed no adverse reactions. These results suggest that DiHM (pH 7) assures efficacy and safety and is a good candidate for soft tissue augmentation in both humans and animals.

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Long-term outcome of transurethral injection of hyaluronic acid/dextranomer (NASHA/Dx gel) for the treatment of stress urinary incontinence (SUI)

Abstract: Transurethral injection of NASHA/Dx gel in women with SUI is associated with complications and not effective in the long term.

Cited by 9 publications

References 26 publications

Two-year follow-up of an open-label multicenter study of polyacrylamide hydrogel (Bulkamid®) for female stress and stress-predominant mixed incontinence

Two-year follow-up of an open-label multicenter study of polyacrylamide hydrogel (Bulkamid®) for female stress and stress-predominant mixed incontinence

Management of Recurrent or Persistent Stress Urinary Incontinence after Mid‐urethral Sling

Effects of crosslinked dextran in hydroxylpropyl methylcellulose on soft tissue augmentation in rats

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