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首页> 外文期刊>BJU international >Periurethral collagen injection: a long-term follow-up study.
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Periurethral collagen injection: a long-term follow-up study.

机译：尿道周胶原蛋白注射液：一项长期的随访研究。

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OBJECTIVE: To determine the long-term success of the periurethral injection of collagen (Contigen(R), Bard UK) in women with genuine stress incontinence. PATIENTS AND METHODS: Sixty-one women with genuine stress incontinence were enrolled in a trial of periurethral collagen injections between 1 September 1990 and 31 August 1992. They were assessed at 1, 3, 6, 12 and 24 months after the last collagen injection. In 1998, their notes were reviewed, and a standardized questionnaire was sent to 46 women who were still alive and had undergone no further anti-incontinence surgery. RESULTS: Of the 53 women who were either known failures or who had follow-up information beyond 5 years, 26% were subjectively improved. Women who had a maximum urethral closure pressure of >20 cmH2O and those who had urinary incontinence for <10 years before their first injection were more likely to have had long-term success. There was no correlation between long-term success and the number of previous operations, body mass index, age or preoperative pad loss. Neither the number of injection sessions, total volume of collagen injected nor perceived bulking at the time of surgery affected long-term success rates. Of the 14 women who considered themselves subjectively improved, seven had daily incontinence and only one was completely dry. Urinary retention and urinary tract infection were the most common complications. In addition, one woman reported a flare-up of her skin test and transient 'flu-like symptoms 2 weeks after the injection, and one woman developed a right upper lobe pneumonia 2 weeks after the collagen injection. CONCLUSION: The long-term results of periurethral collagen injections are disappointing. We found no evidence to support the use of periurethral collagen injections in women with intrinsic sphincter deficiency, who had a higher failure rate than those with hypermobility. Further research is essential to develop agents that are not immunogenic, produce minimal inflammatory response and yet are durable.
机译：目的：确定在患有真正的压力性尿失禁的女性中，尿道周围注射胶原蛋白（Contigen（R），Bard UK）的长期成功性。患者与方法：1990年9月1日至1992年8月31日期间，有61名患有真正的压力性尿失禁的妇女参加了尿道周围胶原蛋白注射的试验。在最后一次胶原蛋白注射后的1、3、6、12和24个月对她们进行评估。 1998年，对她们的笔记进行了审查，并向46名仍活着且未进行过进一步的失禁手术的妇女发送了标准化问卷。结果：在53名已知失败或有5年以上随访信息的妇女中，有26％的人主观上得到了改善。最大尿道闭合压力> 20 cmH2O的妇女和首次注射前尿失禁少于10年的妇女更有可能取得长期成功。长期成功与以前的手术次数，体重指数，年龄或术前垫块丢失之间无相关性。注射次数，胶原蛋白的注射总量或手术时感觉到的肿胀都不会影响长期成功率。在认为自己能够主观改善的14名女性中，有7名每天都有大小便失禁的情况，只有一名完全干燥。尿retention留和尿路感染是最常见的并发症。此外，一名妇女在注射后两周报告皮肤测试突然发作，并出现短暂的'流感样症状。一名妇女在注射胶原后两周出现右上叶肺炎。结论：尿道周围胶原蛋白注射的长期结果令人失望。我们发现没有证据支持在患有内在括约肌缺乏症的妇女中使用尿道周围胶原蛋白注射，这些妇女的失败率高于那些患有过度活动症的妇女。进一步的研究对于开发非免疫原性，产生最小的炎症反应且持久的药物至关重要。

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