Can Urethral Bulking Agents Salvage Failed Slings?

To evaluate the efficacy of urethral bulking agents for stress urinary incontinence (SUI) in the setting of prior failed sling. This is a retrospective review of patients who underwent urethral bulking agent injections for a primary complaint of SUI following prior failed sling surgery. The outcomes...

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Bibliographic Details
Published in:Urology (Ridgewood, N.J.) N.J.), 2019-02, Vol.124, p.78-82
Main Authors: Dray, Elizabeth V., Hall, Marybeth, Covalschi, Diana, Cameron, Ann P.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Collagen - administration & dosage
Dimethylpolysiloxanes - administration & dosage
Female
Humans
Injections, Intralesional
Middle Aged
Retrospective Studies
Suburethral Slings
Treatment Failure
Treatment Outcome
Urethra
Urinary Incontinence, Stress - therapy
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Summary:To evaluate the efficacy of urethral bulking agents for stress urinary incontinence (SUI) in the setting of prior failed sling. This is a retrospective review of patients who underwent urethral bulking agent injections for a primary complaint of SUI following prior failed sling surgery. The outcomes assessed were patient reported improvement, need for further interventions for incontinence and validated questionnaires. Values for questionnaires were obtained from the patient's preprocedure visit, at the first visit following their last injection and at their most recent visit within our system. Over the study period, 73 patients underwent urethral bulking agent injection following failed sling. Thirty-eight patients received Macroplastique injections and 35 had collagen injections. On average, patients underwent 2.6 injections. Seventy-one percent of patient reported at least partial symptom resolution at first postinjection follow-up. Validated questionnaire responses also improved at short-term follow-up (mean difference in American Urological Association Symptom Index-3.8, Michigan Incontinence Symptom Index-5.1, P
ISSN:0090-4295
1527-9995
DOI:10.1016/j.urology.2018.09.019