Collagen injections can help some incontinence patients when surgery fails

Collagen injections can benefit women who still suffer from stress urinary incontinence (SUI) even after urethral or periurethral surgery, a UT Southwestern Medical Center researcher has found.

"Patients with persistent or recurrent incontinence often do not wish to undergo another surgery," said Dr. Philippe Zimmern, professor of urology and the study's lead author. "The collagen injection is also a good alternative for those who cannot afford recovery time from surgery or are too medically unfit or frail to undergo a second surgical intervention."

The prevalence of SUI is higher in women than men. While not life threatening, the condition can socially cripple those afflicted because of its embarrassing nature. Despite surgical advancements for treatment, existing procedures sometimes fail. Collagen has been used to treat SUI because its injection into the tissue surrounding the urethra tightens the urethral sphincter and stops urine from leaking.

The study, published in the February edition of the Journal of Urology, reviewed the records of patients who underwent periurethral collagen injection between January 2000 and December 2006. Patients were anesthetized briefly while the collagen was injected. Of the 31 patients, 93 percent (29 women) considered themselves clinically improved or cured.

Dr. Zimmern and his colleagues also used a 3-D ultrasound to define the location and volume of collagen remaining in the urethral wall several months after the original injection. In patients who still suffered from SUI, a second injection was considered when the ultrasound indicated there was asymmetrical or low collagen volume. If the ultrasound showed adequate collagen levels but the patient still suffered from SUI, a different therapy was recommended.

"Women need to know they do not have to live with SUI," said Dr. Zimmern. "Although collagen injections might not work for everyone, the option is out there, and patients need to communicate with their physicians that they are afflicted with the condition to discover what treatments are possible."

Visit www.utsouthwestern.org/urology to learn more about UT Southwestern's clinical services in urology.