Skip to main content

Advertisement

SpringerLink
Log in

Patient-perceived outcomes in the treatment of stress urinary incontinence: focus on urethral injection therapy

  • Review Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Intervention for stress urinary incontinence (SUI) is generally focused on minimizing urinary leakage. However, the overall impact of SUI therapy on patients’ quality of life is, arguably, more important than leakage outcomes. We performed a literature search to investigate the effect of urethral injection therapy on quality of life. Significant quality-of-life improvements have been observed with a number of injectable agents, while there is a distinct lack of correlation between subjective and objective outcomes. Two studies comparing urethral injection therapy with surgical intervention found superior objective efficacy with surgery, but no significant differences in quality-of-life improvements. Personal goals of patients undergoing urethral injection are yet to be explored, but there may be willingness to trade a lower success rate in favor of a more minor treatment procedure. In conclusion, quality-of-life improvements after urethral injection appear significant and comparable to those obtained with surgery. Further study of patients’ own perceptions, pre- and posttreatment, would be valuable.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ware JE, Snow KK, Kosinski M, Gandek B (1993) SF-36 Health Survey: manual and interpretation guide. The Health Institute, New England Medical Center, Boston

    Google Scholar 

  2. Kelleher CJ, Pleil AM, Reese PR, Burgess SM, Brodish PH (2004) How much is enough and who says so? BJOG 111:605–612

    Article  PubMed  Google Scholar 

  3. Patrick DL, Martin ML, Bushnell DM, Yalcin I, Wagner TH et al (1999) Quality of life of women with urinary incontinence: further development of the incontinence quality of life instrument (I-QOL). Urology 53:71–76

    Article  PubMed  CAS  Google Scholar 

  4. Bent AE, Foote J, Siegel S, Faerber G, Chao R et al (2001) Collagen implant for treating stress urinary incontinence in women with urethral hypermobility. J Urol 166:1354–1357

    Article  PubMed  CAS  Google Scholar 

  5. Winters JC, Chiverton A, Scarpero HM, Prats LJ Jr (2000) Collagen injection therapy in elderly women: long-term results and patient satisfaction. Urology 55:856–861

    Article  PubMed  CAS  Google Scholar 

  6. Poon CI, Zimmern PE, Wilson TS, Defreitas GA, Foreman MR (2005) Three-dimensional ultrasonography to assess long-term durability of periurethral collagen in women with stress urinary incontinence due to intrinsic sphincter deficiency. Urology 65:60–64

    Article  PubMed  Google Scholar 

  7. Fianu-Jonasson A, Larsson G, Farrelly E (2005) The Zuidex system for the treatment of stress urinary incontinence: 36-month follow-up. Abstract no. 617. In: International Continence Society (ICS) 35th annual meeting, Montreal, Canada, 28 August–2 September 2005

  8. van Kerrebroeck P, ter Meulen F, Larsson G, Farrelly E, Edwall L et al (2004) Efficacy and safety of a novel system (NASHA/Dx copolymer using the Implacer device) for treatment of stress urinary incontinence. Urology 64:276–281

    Article  PubMed  Google Scholar 

  9. Chapple C, Haab F, Cervigni M, Dannecker C, Fianu-Jonasson A et al (2005) An open, multicentre study of NASHA/Dx gel via the Implacer for the treatment of stress urinary incontinence. Eur Urol 48:488–494

    PubMed  CAS  Google Scholar 

  10. Tamanini JT, D’Ancona CA, Netto NR Jr (2004) Treatment of intrinsic sphincter deficiency using the Macroplastique Implantation System: two-year follow-up. J Endourol 18:906–911

    Article  PubMed  Google Scholar 

  11. Kothari S, Pitkin J (2002) Efficacy of periurethral silicone implants (Macroplastique) in the treatment of urinary stress incontinence and stress incontinence with detrusor overactivity—a questionnaire study. Abstract 280. In: Annual Meeting of the International Continence Society, Heidelberg, Germany, 28–30 August 2002

  12. Anders K, Khullar V, Cardozo L, Bidmead J, Athanasiou S et al (2002) Contigen or Macroplastique? A five-year follow-up. Abstract 281. In: Annual Meeting of the International Continence Society, Heidelberg, Germany, 28–30 August 2002

  13. Dmochowski R, Herschorn S, Corcos J, Radomski S, Pommerville P et al (2003) Multicenter randomized controlled study to evaluate Uryx® urethral bulking agent in treating female stress urinary incontinence. Abstract 341. In: 33rd Annual Meeting of the International Continence Society, Florence, Italy, 5–9 October 2003

  14. Bano F, Barrington JW, Dyer R (2005) Comparison between porcine dermal implant (Permacol) and silicone injection (Macroplastique) for urodynamic stress incontinence. Int Urogynecol J Pelvic Floor Dysfunct 16:147–150

    Article  PubMed  CAS  Google Scholar 

  15. Corcos J, Collet JP, Shapiro S, Herschorn S, Radomski SB et al (2005) Multicenter randomized clinical trial comparing surgery and collagen injections for treatment of female stress urinary incontinence. Urology 65:898–904

    Article  PubMed  CAS  Google Scholar 

  16. Maher CF, O'Reilly BA, Dwyer PL, Carey MP, Cornish A et al (2005) Pubovaginal sling versus transurethral Macroplastique for stress urinary incontinence and intrinsic sphincter deficiency: a prospective randomised controlled trial. BJOG 112:797–801

    Article  PubMed  Google Scholar 

  17. Steele AC, Kohli N, Karram MM (2000) Periurethral collagen injection for stress incontinence with and without urethral hypermobility. Obstet Gynecol 95:327–331

    Article  PubMed  CAS  Google Scholar 

  18. Chrouser KL, Fick F, Goel A, Itano NB, Sweat SD et al (2004) Carbon coated zirconium beads in beta-glucan gel and bovine glutaraldehyde cross-linked collagen injections for intrinsic sphincter deficiency: continence and satisfaction after extended follow-up. J Urol 171:1152–1155

    Article  PubMed  CAS  Google Scholar 

  19. van Kerrebroeck P, ter Meulen F, Larsson G, Farrelly E, Edwall L et al (2004) Treatment of stress urinary incontinence using a copolymer system: impact on quality of life. BJU Int 94:1040–1043

    Article  PubMed  Google Scholar 

  20. Madjar S, Covington-Nichols C, Secrest CL (2003) New periurethral bulking agent for stress urinary incontinence: modified technique and early results. J Urol 170:2327–2329

    Article  PubMed  Google Scholar 

  21. Chapple C, Wein A, Brubaker L, Dmochowski R, Espuña Pons M et al (2005) Stress incontinence injection therapy: what is best for our patients? Eur Urol 48:552–565

    Article  PubMed  Google Scholar 

  22. Lightner D, Calvosa C, Andersen R, Klimberg I, Brito CG et al (2001) A new injectable bulking agent for treatment of stress urinary incontinence: results of a multicenter, randomized, controlled, double-blind study of Durasphere. Urology 58:12–15

    Article  PubMed  CAS  Google Scholar 

  23. Kershen RT, Appell RA (2002) De novo urge syndrome and detrusor instability after anti-incontinence surgery: current concepts, evaluation, and treatment. Curr Urol Rep 3:345–353

    PubMed  Google Scholar 

  24. Chaliha C, Stanton SL (1999) Complications of surgery for genuine stress incontinence. BJOG 106:1238–1245

    Article  CAS  Google Scholar 

  25. Elkadry EA, Kenton KS, FitzGerald MP, Shott S, Brubaker L (2003) Patient-selected goals: a new perspective on surgical outcome. Am J Obstet Gynecol 189:1551–1557

    Article  PubMed  Google Scholar 

  26. Mahajan ST, Elkadry EA, Shott S, Kenton K, Brubaker L (2006) Patient-centered surgical outcomes: the impact of goal achievement and urge incontinence on patient satisfaction one year after surgery. Am J Obstet Gynecol 194:722–728

    Article  PubMed  Google Scholar 

  27. Robinson D, Anders K, Cardozo L, Bidmead J, Dixon A et al (2003) What do women want? Interpretation of the concept of cure. J Pelvic Med Surg 9:273–277

    Article  Google Scholar 

  28. Dmochowski RR, Appell RA (2000) Injectable agents in the treatment of stress urinary incontinence in women: where are we now? Urology 56:32–40

    Article  PubMed  CAS  Google Scholar 

  29. Lightner DJ, Itano NB, Sweat SD, Chrouser KL, Fick F (2002) Injectable agents: present and future. Curr Urol Rep 3:408–413

    PubMed  Google Scholar 

  30. Khullar V, Cardozo LD, Abbott D, Anders K (1997) GAX collagen in the treatment of urinary incontinence in elderly women: a two year follow up. BJOG 104:96–99

    Article  CAS  Google Scholar 

  31. Hartanto VH, Lightner DJ, Nitti VW (2003) Endoscopic evacuation of Durasphere. Urology 62:135–137

    Article  PubMed  Google Scholar 

  32. McKinney CD, Gaffey MJ, Gillenwater JY (1995) Bladder outlet obstruction after multiple periurethral polytetrafluoroethylene injections. J Urol 153:149–151

    Article  PubMed  CAS  Google Scholar 

  33. Sweat SD, Lightner DJ (1999) Complications of sterile abscess formation and pulmonary embolism following periurethral bulking agents. J Urol 161:93–96

    Article  PubMed  CAS  Google Scholar 

  34. Barranger E, Fritel X, Kadoch O, Liou Y, Pigne A (2000) Results of transurethral injection of silicone micro-implants for females with intrinsic sphincter deficiency. J Urol 164:1619–1622

    Article  PubMed  CAS  Google Scholar 

  35. Janowsky EC, Kupper LL, Hulka BS (2000) Meta-analyses of the relation between silicone breast implants and the risk of connective-tissue diseases. N Engl J Med 342:781–790

    Article  PubMed  CAS  Google Scholar 

  36. Henly DR, Barrett DM, Weiland TL, O’Connor MK, Malizia AA et al (1995) Particulate silicone for use in periurethral injections: local tissue effects and search for migration. J Urol 153:2039–2043

    Article  PubMed  CAS  Google Scholar 

  37. Pannek J, Brands FH, Senge T (2001) Particle migration after transurethral injection of carbon coated beads for stress urinary incontinence. J Urol 166:1350–1353

    Article  PubMed  CAS  Google Scholar 

  38. Stenberg AM, Larsson G, Johnson P (2003) Urethral injection for stress urinary incontinence: long-term results with dextranomer/hyaluronic acid copolymer. Int Urogynecol J Pelvic Floor Dysfunct 14:335–338

    Article  PubMed  CAS  Google Scholar 

  39. Hullfish KL, Bovbjerg VE, Gibson J, Steers WD (2002) Patient-centered goals for pelvic floor dysfunction surgery: what is success, and is it achieved? Am J Obstet Gynecol 187:88–92

    Article  PubMed  Google Scholar 

  40. Tamanini JT, D’Ancona CA, Tadini V, Netto NR Jr (2003) Macroplastique implantation system for the treatment of female stress urinary incontinence. J Urol 169:2229–2233

    Article  PubMed  Google Scholar 

Download references

Acknowledgement

The development of this manuscript was supported by an unrestricted educational grant from Q-Med AB, Uppsala, Sweden.

Author information

Authors and Affiliations

  1. Urology Research Department, J Floor, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, UK

    Christopher R. Chapple

  2. Department of Obstetrics and Gynecology, Loyola University Medical Center, Maywood, IL, USA

    Linda Brubaker

  3. Department of Urology, Tenon Hospital, Paris, France

    François Haab

  4. Department of Urology, University Hospital Maastricht, Maastricht, The Netherlands

    Philip van Kerrebroeck

  5. Department of Urogynaecology, King’s College Hospital, London, UK

    Dudley Robinson

Authors
  1. Christopher R. Chapple
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Linda Brubaker
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. François Haab
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Philip van Kerrebroeck
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Dudley Robinson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christopher R. Chapple.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chapple, C.R., Brubaker, L., Haab, F. et al. Patient-perceived outcomes in the treatment of stress urinary incontinence: focus on urethral injection therapy. Int Urogynecol J 18, 199–205 (2007). https://doi.org/10.1007/s00192-006-0148-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-006-0148-0

Keywords

Search

Navigation