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Transurethral Injection of Silicone Microimplants for Intrinsic Urethral Sphincter Deficiency

KOELBL, HEINZ MD; SAZ, VELI MD; DOERFLER, DANIELA MD; HAEUSLER, GUENTHER MD; SAM, CHRISTINE MD; HANZAL, ENGELBERT MD
Obstetrics & Gynecology: September 1998
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Objective To assess the short-term efficacy of transurethral injection of silicone microimplants in women with intrinsic sphincter deficiency.

Methods During January 1995 and December 1996, 32 women (mean age 64.3 years, range 39-85 years) with type III stress incontinence (intrinsic sphincter deficiency) underwent transurethral injection of silicone microimplants under general anesthesia. Twenty-eight had undergone previous continence surgery. Subjective and urodynamic assessments were made at 6 and 12 months after injection to evaluate success and short-term effects.

Results Objective and subjective success rates were 75% and 59% at 6 and 12 months, respectively. Injections of silicone microimplants significantly increased maximum urethral closure pressure (maximum urethral pressure at rest: 34.40 ± 16.46 cm H2O, 95% confidence interval [CI] 28.55, 40.25 versus 25.35 ± 10.78 cm H2O, 95% CI 21.52, 29.18; P = .027). There were no complications after surgery up to 1 year.

Conclusion Transurethral silicone injections were effective in 60% of cases of intrinsic sphincter deficiency, although there was a time-dependent decrease.

Address reprint requests to: Heinz Koelbl, MD, Department of Gynecology and Obstetrics, University Hospital of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria. E-mail: heinz.koelbl@univie.ac.at

© 1998 The American College of Obstetricians and Gynecologists