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Commented Abstracts

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  • Complications of periurethral injections of collagen for Stress Urinary Incontinence.
    Urology Division, Surgery Deparment, University of British Colombia, Vancouver, B.C., Canada. J. Urol., v.159, p.806-7, 1998.


Objectives: The periurethral collagen injection was defended as a safe and effective measure of treatment for stress urinary incontinence. This study was conducted to determine the complications associated with a collagen transurethral injection for the treatment of SUI in women. We report the incidence and conduct of the adverse effects.
Materials and Methods: A total of 337 women with at least 1 year of history, physical findings and urodinamical abnormalities consistent with SUI, who need linings or clothing protectors and who did not have cystocele or just had first degree, were accepted in this prospective study. Adverse effects were documented at each continuation.
Results: Each recurrence of the urinary urgency with incontinence, was the more frequent and serious complication, ocurring in 12.6 % of the patients and in many the symptoms were revealed as being irreversible. Hematuria (5 % of the patients) and urinary retention (1.9 %) lasted a short period of time and were resolved spontaneously. Late reaction in the site of the cutaneous test happened in (0.9 %) of the patients (3) and was associated with arthralgia in 2.
Conclusions: Contrary to previous accounts in which the periurethral injection of collagen is free of complications, we found a global incidence of 20 % of complication risk.


From 1989, collagen treated with gluteraldehyde has been proposed as a treatment of Stress Urinary Incontinence (SUI ), mainly in the cases of instrinsic sphincter deficiency (ISD). The collagen is easy to be injected, it does not migrate to distant organs and has a low allergenic potential. It would have as an advantage in relation to other SUI treatments the simplicity of the execution of the method and the low incidence of adverse effects. The success rate varies from 68 to 94 % in the dependency of the technique used and the time of follow up 1,2,3. The main disadvantages of the method are the reduction of the efficiency in longer follow up and the high cost for the realization of the procedure. Stothers et al show the complications, however, might result from this method of treatment, particularly when there is a rigorous follow up. The complications however, have been, in their majority, transitory and not very significant with the exception of the urinary urgency with incontinence, present in 12.6% of the patients.

Aparecido Donizete Agostinho

1. MC GUIRE, E.J.; APPELL, R. Transurethral collagen injection for urinary incontinence. Urology, v.43, p.413-5, 1994.
2. O'CONNELL, H.E.; MC GUIRE, E. J.; ABOSEIF, S. et al Transurethral collagen therapy in women. J. Urol., v.154, p.1463-5, 1995.
3. WINTERS, J.C.; APPELL, R. Periurethral injection of collagen in the treatment of intrinsic sphincter deficiency in the female patient. Urol. Clin. N. Amer., v.22, p.673-8, 1995.

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