Three-dimensional ultrasonography to assess long-term durability of periurethral collagen in women with stress urinary incontinence due to intrinsic sphincter deficiency

Poon, Christina I.; Zimmern, Philippe E.; Wilson, Timothy H.; Defreitas, Gina A.; Foreman, Melissa

doi:10.1016/j.urology.2004.08.034

Cited by 24 publications

(6 citation statements)

References 20 publications

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“…Although transperineal ultrasonography has not been compared with anatomic studies, the inner part of the ES ring probably represents the longitudinal muscle, which in most studies could not be distinguished ultrasonographically from the ES, and can attain the same thickness as the ES. 21 The puborectalis muscle is visualized as a U-shaped echogenic area surrounding the ES posteriorly near the anorectal junction, forming the anorectal angle. The mucous folds are visible as structures of mixed echogenicity with a characteristic radiation from the central area, or "star sign."…”

Section: Imaging Methods and The Normal Ultrasonographic Anatomy Of Tmentioning

confidence: 99%

“…They showed that procedure success significantly correlated not with the volume but rather with the collagen distribution in the periurethral area. Poon et al 21 found that the volume of the bulking agent and its periurethral configuration (circumferential or horseshoeshaped) correlated with the duration of improvement. This might aid in developing a rational treatment approach and reinjection planning.…”

Section: Valsky and Yagelmentioning

confidence: 99%

“…32 Endoanal ultrasonography is the most widely studied technique, showing an anatomic correlation with sphincter complex structures similar to those shown in direct comparative studies. 21 Magnetic resonance imaging of the anal sphincter with a body coil or endoluminal coil has also been widely studied and allows for accurate description of the anatomy of the anal canal. 25 Reference data have been published for many normal parameters of the anal sphincter complex as measured by endoanal ultrasonography in nulliparous and pregnant women of different ages 33 and by endoluminal and phased array MRI.…”

Section: Anatomy Continued: the Posterior Compartmentmentioning

confidence: 99%

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Three-Dimensional Transperineal Ultrasonography of the Pelvic Floor

Valsky

2007

Journal of Ultrasound in Medicine

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Section: Imaging Methods and The Normal Ultrasonographic Anatomy Of Tmentioning

confidence: 99%

Section: Valsky and Yagelmentioning

confidence: 99%

Section: Anatomy Continued: the Posterior Compartmentmentioning

confidence: 99%

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Three-Dimensional Transperineal Ultrasonography of the Pelvic Floor

Valsky

2007

Journal of Ultrasound in Medicine

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“…9 We speculate that multiple factors contributed to pseudoabscess formation in our patient: a large volume of agent was injected, she received previous pelvic radiation therapy, the patient is diabetic, and she is morbidly obese with a body mass index greater than 42 kg/m 2 .…”

Section: Discussionmentioning

confidence: 86%

Delayed Presentation of Pseudoabscess Secondary to Injection of Pyrolytic Carbon-Coated Beads Bulking Agent

Berger

Morgan

2012

Female Pelvic Medicine &Amp; Reconstructive Surgery

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Background Periurethral masses after injection of Durasphere® bulking material have been previously reported to occur within 12-18 months of administration of the agent. Methods We present a case report of an anterior vaginal wall mass resulting from a pseudoabscess containing Durasphere® agent 5 years after injection. A literature review of urethral bulking agent complications and imaging is also provided. Results The patient's anterior vaginal wall mass was thought to be due to a pseudoabscess secondary to injection of bulking agent. Pelvic imaging was helpful both in identifying the mass and in surgical planning. The patient was successfully treated by outpatient transvaginal resection of the material. Conclusions Urethral bulking agents, while generally safe and effective in the treatment of stress urinary incontinence, can lead to formation of pseudoabscesses. Although these are usually recognized within the first 18 months after injection, they may not be identified until several years later.

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“…Two‐dimensional US (2D‐US) has been the most widely applied technique for imaging of bulking agents, primarily because of its availability and significantly lower cost compared with cross‐sectional imaging using CT or MRI [5]. As with 3D‐US, most publications utilizing 2D‐US to assess urethral bulking agents have applied the technique after injection of collagen [6–8]. Most have tried to define imaging characteristics and the periurethral position/configuration in an attempt to determine the mechanism by which collagen treats SUI [8].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the precision of transurethral endoscopic versus ultrasound‐guided application of injectables

et al. 2007

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OBJECTIVE To compare the precision of transurethral endoscopic‐ vs ultrasound (US)‐guided injections, as transurethral application of various injectables under endoscopic view are widely used to treat urinary incontinence. MATERIAL AND METHODS Bovine collagen was injected into the lower urinary tract in 20 dead female pigs. In each pig five depots of collagen were injected and there were five pigs in each group. In group I collagen was injected into the urethral wall under endoscopic control. In group II collagen depots were injected periurethrally under endosocopic guidance. In group III collagen was injected into the urethral wall under US control. In group IV collagen depots were injected periurethrally under US guidance. A transurethral US probe (6 F, 15 MHz) and injection device were used for transurethral US‐guided injections. In all pigs the urethra and the periurethral tissue were removed after injection and investigated using anatomical preparations and histological sections. RESULTS In group I only two collagen depots were actually located in the urethral wall in two pigs (two of 25 depots, 8%). In group II five depots in two pigs were located in the urethral wall (five of 25 depots, 20%). The periurethral collagen depots were found to spread out in the loose connective and fat tissue around the urethra. In group III all US‐guided injections of collagen were situated in the urethral wall and in group IV they were all located periurethrally. CONCLUSIONS The present study shows that endoscopic application of injectables is an inaccurate technique, while US‐guided injections are precise. US‐guided injection enables excellent control of the therapeutic procedure.

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Three-dimensional ultrasonography to assess long-term durability of periurethral collagen in women with stress urinary incontinence due to intrinsic sphincter deficiency

Cited by 24 publications

References 20 publications

Three-Dimensional Transperineal Ultrasonography of the Pelvic Floor

Three-Dimensional Transperineal Ultrasonography of the Pelvic Floor

Delayed Presentation of Pseudoabscess Secondary to Injection of Pyrolytic Carbon-Coated Beads Bulking Agent

Comparison of the precision of transurethral endoscopic versus ultrasound‐guided application of injectables

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