Complete Urinary Obstruction Following Periurethral Polytetrafluoroethylene Injection for Urinary Incontinence

Abstract

We report a unique case of foreign body granulomatous reaction after periurethral polytetrafluoroethylene injection causing complete urinary obstruction. Urinary obstruction in the immediate postoperative period and granuloma formation following polytetrafluoroethylene injection are not unusual. To our knowledge delayed complete urinary obstruction after polytetrafluoroethylene injection has not been described previously in the urological literature.

Novel Bioceramic Urethral Bulking Agents Elicit Improved Host Tissue Responses in a Rat Model

“…UBT-induced complications were most pronounced with the use of polytetrafluoroethylene (Telfon), popularized in the 1970s [ 21 ]. Teflon is not a biologically inert substance, which leads to significant scarring as well as a foreign body granulomatous reaction locally and distantly from migration of the particles [ 22 , 23 ].…”

Complications of surgery for genuine stress incontinence

“…Delayed voiding is the most common complication after sling operations, especially with the use of synthetic materials 69–71 , and up to 8% of women may require long term self catheterisation 72–74 . Although voiding difficulties after periurethral injections are uncommon 75 , temporary voiding dysfunction is often seen 76–78 . Stanton and Monga 78 studied 32 elderly women who underwent periurethral collagen injection and found brief urinary retention in 7 women (22%), requiring prolonged catheterisation in only one.…”

Endoscopic Treatment of Reflux: Experimental Study and Review of Teflon® and Collagen

“…The longest follow-up of human histological response is 16 years [12], There have been some reports of late apparent enlarge ment of the granuloma at the site of injection: a complete urinary obstruction following periurethral Teflon injec tion for urinary incontinence [5], an enlarged vaginal peri urethral granuloma and the development of a neck swell ing many months after Polytef injection into paralyzed vocal cords simulating a thyroid tumor [62,71,72]. This has never been described in reflux.…”