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Urethral injection for stress urinary incontinence: long-term results with dextranomer/hyaluronic acid copolymer

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Abstract

Urethral injection is a convenient, minimally invasive means of treating stress urinary incontinence (SUI). We present long-term follow-up data from 20 patients originally recruited in 1994–95 (mean age 67 years) to receive urethral injection with dextranomer/hyaluronic acid (Dx/HA) copolymer. The majority of patients had failed previous therapy for SUI. If the first injection was unsuccessful, up to two further injections were offered. Only 3 patients (15%) failed to show a response to treatment. Sixteen women were reassessed during 2001 (4 had died of causes unrelated to the study treatment). A sustained response throughout the follow-up period was reported in 9/16 patients (57%), with incontinence recurring in just 4 (25%). None of the 7 patients with persistent or recurrent incontinence were cured by subsequent treatments, including surgery. In conclusion, urethral injection with Dx/HA copolymer offers promising long-term efficacy in the treatment of SUI, regardless of old age or failure to respond to previous therapy.

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Abbreviations

SUI:

Stress urinary incontinence

VUR:

Vesicoureteral reflux

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Authors and Affiliations

  1. Department of Gynecology, Enköping Hospital, Box 908, SE-745 25, Enköping, Sweden

    Å. M. Stenberg

  2. Central Hospital of Västerås, Västerås, Sweden

    G. Larsson

  3. Division of Obstetrics and Gynecology, University Hospital, Uppsala, Sweden (now retired)

    P. Johnson

Authors
  1. Å. M. Stenberg
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  2. G. Larsson
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  3. P. Johnson
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Corresponding author

Correspondence to Å. M. Stenberg.

Additional information

Editorial Comment: These investigators present long-term follow-up on a newer periurethral injectable material, dextranomer/hyaluronic copolymer, for stress incontinence. The limited sample size of 20 patients with only 13 patients evaluable at 5 years, is one major disadvantage of this study; however, 69% of patients had a sustained response to urethral injection on post-operative subjective and objective testing which represents an improvement over existing injectable materials. Advantages of this material over some of the presently available agents include improved durability, lack of need for skin-testing and no reported autoimmune or migratory complications. Certainly, long-term data on more patients would be appropriate.

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Stenberg, Å.M., Larsson, G. & Johnson, P. Urethral injection for stress urinary incontinence: long-term results with dextranomer/hyaluronic acid copolymer. Int Urogynecol J 14, 335–338 (2003). https://doi.org/10.1007/s00192-003-1075-y

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  • DOI: https://doi.org/10.1007/s00192-003-1075-y

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