Multicenter Prospective Randomized 52-Week Trial of Calcium Hydroxylapatite Versus Bovine Dermal Collagen for Treatment of Stress Urinary Incontinence

Mayer, Robert; Dmochowski, Roger R.; Appell, Rodney A.; Sand, Peter K.; Klimberg, I.W.; Jacoby, Karny; Graham, Cynthia A.; Snyder, Jeffrey A.; Νitti, Victor W.; Winters, J. Christian

doi:10.1016/j.urology.2007.01.050

Cited by 95 publications

(62 citation statements)

References 15 publications

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“…Silicone particles (Macroplastique™), calcium hydroxylapatite (Coaptite™), ethylene vinyl alcohol (Uryx™), carbon-coated zirconium beads (Durasphere™), porcine dermal implant (Permacol™), and glutaraldehyde crosslinked bovine collagen (Contigen™) show equal effectiveness [10,[32][33][34], with variations in long-and short-term outcomes [34][35][36]. Cure or improvement rates vary between 62 % and 80 % or 20 % and 86 %, depending on the source used [9,10,37].…”

Section: Discussionmentioning

confidence: 99%

Bulking agents: an analysis of 500 cases and review of the literature

et al. 2012

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Introduction and hypothesis Stress urinary incontinence (SUI) is common, impacts women's quality of life, and generates high costs. Physiotherapy is the first-line therapy, and if it fails, suburethral slings are the gold standard in SUI surgery. Bulking agents injected periurethrally might be a beneficial alternative, but there is a paucity of data on bulking therapy. The aim of this study was to prospectively analyze the efficacy and safety of bulking agents in the setting of a tertiary referral center. Methods In the last 13 years, 514 elderly women with SUI were treated by injection therapy with either collagen (Contigen®), hyaluronic acid (Zuidex®), ethylene vinyl alcohol (Tegress®), or polyacrylamide hydrogel (Bulkamid®). Subjective and objective outcome was recorded at the 12-month postoperative appointment using the King's Health Questionnaire, visual analogue scale (VAS) describing their incontinence severity, standardized pad test, and urethral pressure profile.Results Demographic data were equally distributed in all four groups of agents used. Sixty-one patients were lost to follow-up (10.6 %). Statistically significant changes were found for maximum urethral closure pressure (MUCP), pad weight, and VAS before and after bulking for the four agents used. Pad test was negative in 73.2 % of patients after bulking therapy. Subjective assessment showed improvements in general health and role limitations. The overall complication rate was low for all agents. Conclusions This study shows improvement in incontinence after bulking therapy according to subjective and objective outcomes in an elderly population. In contrast to earlier reports, side effects due to injections were few and mild. We can advocate bulking therapy for treating SUI, as it is simple, safe, and shows both objective and subjective improvement and relief.

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Section: Discussionmentioning

confidence: 99%

Bulking agents: an analysis of 500 cases and review of the literature

et al. 2012

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“…9 PAHG (Bulkamid™), 10 calcium hydroxyapatite (Coaptite™), 11 pyrolytic carbon (Durasphere™), 12 and polydimethylsilaxone (Macroplastique™) 13 have demonstrated non-inferiority to collagen in randomized, controlled studies.…”

Section: Efficacymentioning

confidence: 99%

Periurethral bulking agents for female stress urinary incontinence in Canada

Mamut¹,

Carlson²

2017

CUAJ

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Urethral bulking aims to improve urethral mucosal coaptation, and thus outlet resistance, in an effort to limit stress-induced leakage. While efforts have been made to employ bulking agents to treat stress urinary incontinence (SUI) for more than 100 years, we remain wanting for the perfect injectable. Regardless of the agent studied, efficacy is modest at best, repeat injections are the norm, and longterm followup is conspicuously lacking. This treatment, however, fills an important need in our armamentarium against SUI, serving those patients who are not candidates for more invasive interventions and those with multiple prior failed surgeries. This review offers a contemporary discussion on the role of periurethral bulking therapy in Canada, along with practical aspects of its application.

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“…After a few months, the gel carrier degrades and enables ingrowth of a new tissue around the CaHA particles. The particles, surrounding the new tissue formation, compose the long term bulking effect [23]. The high dryness rates of the patients in the late follow-up may be contributed to the new structural composition of the CaHA particles in the soft tissue.…”

Section: Discussionmentioning

confidence: 99%

Efficiency of Injection Therapy for Stress Incontinence:a Retrospective Evaluation of 8 Years Results

Ener¹

2013

Ann Clin Anal Med

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ÖzetAmaç: Stres üriner inkontinansı olan seçilmiş kadın hastalarda, transüretral Coaptite® enjeksiyonunun etkinliğini ve BMİ, menopozal durum önceden geçi-rilmiş anti-inkontinans cerrahisinin prediktif değerini inceledik. Gereç ve Yön-tem: Genel anestezi açısından yüksek risk taşıyan, transüretral enjeksiyon tedavisi uygulanmış olan, stres üriner inkontinanslı 45 kadın hasta retrospektif olarak incelendi. Enjeksiyon sonrası dönemde 1. ay, 12. ay ve 8. yıl kontrollerinde ICIQ-SF, QoL skorları ve ped testi değerlendirmeleri yapıldı. Bulgular:Enjeksiyon öncesi dönemle karşılaştırıldığında, 1. ve 12. ay ped testi sonuçla-rı anlamlı, son kontroldeki ped testi sonucu ise anlamsız olarak bulundu. Sorgulama formları incelendiğinde, ped testine benzer şekilde enjeksiyon sonrası dönemdeki skorlar istatistiksel olarak anlamlı bulundu. Ancak ped testinden farklı olarak, her 2 sorgulama formunda da son kontroldeki skorların, istatistiksel olarak anlamlı değişiklikler gösterdiği tespit edildi. Transüretral enjeksiyon tedavisinin başarısı menopozal durum, BMİ ve önceden geçirilmiş antiinkontinans cerrahisine gore değerlendirildi. QoL ve ICIQ-SF skoru %değişim-leri ve ped testi değerleri, uzun dönem takipte, enjeksiyon öncesi dönemle karşılaştırıldığında, istatistiksel olarak anlamlı bulunmadı. Tartışma: Transü-retral enjeksiyon, SÜİ'ı olan seçilmiş hastalarda kolay ve etkili bir yöntemdir.BMİ, önceden geçirilmiş anti-inkontinans cerrahisi ve menopozal durum, uzun dönem takipte, transüretral enjeksiyon sonuçlarını etkilememektedir. Anahtar KelimelerSÜİ; Transüretral Enjeksiyon; VKİ; Geçirilmiş Anti-İnkontinans Cerrahisi; Menopozal Durum Abstract Aim: To evaluate the long term affectivity of transurethral Calcium Hydroxylapatite (CaHA; Coaptite®) injection therapy and the predictive importance of Body Mass Index (BMI), menopausal status and previous anti-incontinence surgery in selected female patients with stress urinary incontinence (SUI). Material and Method: Forty-five female patients with SUI, and having high risks for general anesthesia, received transurethal injection therapy, were evaluated retrospectively. First month, 12th month, and 8th year of postinjection period were evaluated in terms of International Consultatiton on Incontinence Questionnaire Short Form (ICIQ-SF), Quality of Life (QoL) score, and pad test. Results: While the pad test of 1st and 12th months' showed statistically significance, the pad test of last visit was found insignificant, when compared with pre-injection term. Through the evaluations of questionnaire forms similar to the pad test, it was observed that the post-injection scores showed statistically significance. However, unlike to the pad test, for each of both questionnaires, statistically significant differences were detected at the last examination's scores, as well. When we examined the success of the transurethral injection treatment according to menopausal status, BMI, and previous anti-incontinence surgery, it was observed that QoL and ICIQ-SF score %variation, and 24 hr pad test value...

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Multicenter Prospective Randomized 52-Week Trial of Calcium Hydroxylapatite Versus Bovine Dermal Collagen for Treatment of Stress Urinary Incontinence

Cited by 95 publications

References 15 publications

Bulking agents: an analysis of 500 cases and review of the literature

Bulking agents: an analysis of 500 cases and review of the literature

Periurethral bulking agents for female stress urinary incontinence in Canada

Efficiency of Injection Therapy for Stress Incontinence:a Retrospective Evaluation of 8 Years Results

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