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Nonsurgical transurethral collagen denaturation for stress urinary incontinence in women: 18‐month results from a prospective long‐term study
Author(s) -
Elser Denise M.,
Mitchell Gretchen K.,
Miklos John R.,
Nickell Kevin G.,
Cline Kevin,
Winkler Harvey,
Wells W. Glen
Publication year - 2010
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.20875
Subject(s) - medicine , urinary incontinence , quality of life (healthcare) , genitourinary system , adverse effect , distress , prospective cohort study , stress incontinence , surgery , urology , ambulatory , urinary system , clinical psychology , nursing
Aims To evaluate 18‐month safety and durability of efficacy of nonsurgical transurethral collagen denaturation as treatment for stress urinary incontinence (SUI) in women. Methods Study comprised women with SUI due to bladder outlet hypermobility for at least 12 months who failed conservative treatment and had not undergone surgery or bulking agent treatment. This one‐time procedure was performed in a physician's office or ambulatory treatment center. Patients kept voiding diaries and completed the Incontinence Quality of Life (I‐QOL), Urogenital Distress Inventory (UDI‐6), and Patient Global Impression of Improvement measures at baseline and at 3, 6, 12, and 18 months posttreatment. Results At 18 months, intent‐to‐treat analysis revealed that patients experienced significant reductions in the median number of stress leaks daily (0.43; P < 0.006) and weekly (3.0; P < 0.006) versus baseline, with 46.7% reporting a 50% or greater reduction in leakage. Mean I‐QOL score improved 10.9 points (median 8.5; P < 0.0001), with 47.8% having a 10‐point or greater improvement and 50.4% reporting improved symptoms versus baseline. Mean UDI‐6 improvement was 13.0 points, with a stress incontinence subscore improvement of 17.0 points. Overall, 47.0% of patients were “somewhat” or “very” satisfied, and 52.9% would recommend the procedure to a friend. The procedure was shown to be safe and effective, with no new treatment‐related adverse events reported at 18 months. Conclusions Transurethral collagen denaturation resulted in significant improvements in stress leaks and quality of life for at least 18 months. This procedure offers a safe, effective, nonsurgical treatment option for women with SUI. Neurourol. Urodynam. 29:1424–1428, 2010. © 2010 Wiley‐Liss, Inc.