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Incontinence in elderly women: is periurethral collagen an advance?
Author(s) -
Stanton Stuart L.,
Monga Ash K.
Publication year - 1997
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1997.tb11036.x
Subject(s) - medicine , stress incontinence , nocturia , urinary incontinence , prospective cohort study , referral , urology , surgery , urethra , complication , sphincter , detrusor instability , neck of urinary bladder , urinary system , urinary bladder , family medicine
Objective To determine whether periurethral collagen is an effective, safe and practical day‐case procedure to control genuine stress incontinence (urethral sphincter incompetence) in the elderly female. Design Prospective longitudinal study using subjective and objective outcome measures with long term follow up. Setting A teaching hospital tertiary referral centre. Sample Thirty‐two women over 65 years of age with a urodynamic diagnosis of genuine stress incontinence. Results At one year, 22 women (79%) were subjectively cured or improved, and 14 (50%) were objectively cured; at two years, 18 (69%) and 14 (54%), respectively. Symptoms of urgency, urge incontinence, frequency and nocturia improved, while voiding difficulty remained unchanged. Brief urinary retention was encountered in seven women. No long term side effects or complications were encountered. Urodynamic studies suggest that collagen works by preventing premature bladder neck opening through physical stress, rather than by obstruction. This would account for the slight increase in functional urethral length. Conclusion Contigen collagen is a simple and effective day case procedure as an alternative to major surgery and is without significant morbidity or complication. It is ideal for the elderly.