Summary
The failure to store urine secondary to bladder outflow incompetence requires a method of treatment to increase outflow resistance. The methods of injectable therapy as a modality to cause an additional resistance to the flow of urine are discussed. Results obtained with polytetrafluoroethylene (Polytef) and GAX-collagen (Contigen), presently under investigation, are presented. Excellent efficacy was attained for both substances: >90% of women and 75% of men were rendered continent within two treatments. Concerns over particle migration reduce the utility of Polytef, especially in younger patients. Thus far, Contigen appears to be safe as well as efficacious. The best results for injectables were obtained in patients who did not have detrusor problems, had adequate bladder capacity, and showed no anatomic abnormality. Injectable techniques for the treatment of urinary incontinence were well tolerated by patients of all ages and reduced the need for major surgery. This modality of treatment should be added to the armamentarium of individuals involved in the management of urinary incontinence.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Appell RA (1990) Commentary: periurethral polytetrafluor-ethylene (Polytef) injection. In: Whitehead ED (ed) Current operative urology 1990. JP Lippincott, Philadelphia, pp 63–66
Appell RA (1990) New developments: injectables for urethral incompetence in women. Int Urogynecol J 1:117–119
Berg S (1973) Polytef augmentation urethroplasty: correction of surgically incurable incontinence by injection technique. Arch Surg 107:379–381
Deane AM, English P, Hehir M, Williams JP, Worth PHL (1985) Teflon injection in stress incontinence. Br J Urol 57:78–80
Ford CN, Martin DW, Warner TF (1984) Injectable collagen in laryngeal rehabilitation. Laryngoscope 95:513–518
Kaufman M, Lockhart JL, Silverstein MJ, Politano VA (1984) Transurethral polytetrafluorethylene injection for postprostatectomy urinary incontinence. J Urol 132:459–462
Leonard MP, Canning DA, Epstein JI, Gearhart JP, Jeffs RD (1990) Local tissue reaction to the subureteric injection of glutaraldehyde cross-linked bovine collagen in humans. J Urol 143:1209–1212
Malizia AA Jr, Reiman JM, Meyers RP, Sande JR, Barham SS, Benson RC Jr, Dewanjee MK, Utz WJ (1984) Migration and granulomatous reaction after periurethral injection of Polytef (Teflon). JAMA 251:3277–3281
Murless BC (1938) The injection of stress incontinence. J Obstet Gynaecol Br Emp 45:67–73
Politano VA (1978) Periurethral Teflon injection for urinary incontinence. Urol Clin North Am 5:415–422
Politano VA (1982) Periurethral polytetrafluorethylene injection for urinary incontinence. J Urol 127:439–442
Quackels R (1955) Deux incontinences apres adenonectomic queries par injection de paraffine dans de perinee. Acta Urol Belg 23:259–262
Remacle M, Marbaix E (1988) Collagen implants in the human larynx. Arch Otorhinolaryngol 245:203–209
Sachse H (1963) Treatment of urinary incontinence with sclerosing solutions, indications, results, complications. Urol Int 15: 225–244
Schulman CC, Simon J, Wespas E, Germeau F (1983) Endoscopic injection of Teflon for female urinary incontinence. Eur Urol 9:246–247
Stegman SJ, Chu S, Bensch K (1987) A light and electron microscopic evaluation of Zyderm collagen and Zyplast implants in aging human facial skin. Arch Dermatol 123:1644–1649
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Appell, R.A. Injectables for urethral incompetence. World J Urol 8, 208–211 (1990). https://doi.org/10.1007/BF01580022
Issue Date:
DOI: https://doi.org/10.1007/BF01580022