New developments: Injectables for urethral incompetence in women

Abstract

The failure to store urine secondary to bladder outflow incompetence requires a method to increase outflow resistance. Injectable therapy is a modality which causes an additional resistance to the flow of urine. Polytetrafluoroethylene and the use of GAX-Collagen presently under investigation provide excellent efficacy with over 80% of females rendered continent after two treatments. Concerns over particle migration reduce the utility of polytetrafluoroethylene. Thus far the GAX-Collagen appears safe as well as efficacious. The best results with periurethral injections are those females who do not have detrusor abnormalities, who have adequate bladder capacity, and who have no anatomic abnormality. Injectable techniques in the treatment of urinary incompetence are well tolerated by patients of all ages thus reducing the need for major surgery. This modality of treatment should be added to the armamentarium of those individuals involved in the management of females with urinary incontinence.