Results of transurethral injection of silicone micro-implants for females with intrinsic sphincter deficiency

Purpose: We evaluated the medium term efficiency of silicone micro-implants injected in women with intrinsic sphincter deficiency. Materials and Methods: A total of 21 women with intrinsic sphincter deficiency underwent transurethral injection of silicone micro-implants between August 1996 and February 1997. Each patient was assessed preoperatively by questionnaire, physical examination and urodynamic study. The results were evaluated by questionnaire at 1 month, and 1 and 2 years after silicone injection. The outcome was classified as dry in all circumstances, improved or failure. Results: All patients (median age 68 years, range 46 to 83) had undergone previous anti-incontinence or prolapse surgeries. At 1 month 2 patients (10%) were dry and 9 (42%) were improved, and treatment failed in 10 (48%). At 1 year (median 16 months, range 14 to 22) 2 cases (10%) were classified as dry, 8 (38%) improved and 11 (52%) failures. At last followup (median 31 months, range 24 to 34) 4 cases (19%) were classified as dry, 6 (29%) improved and 11 (52%) failures. None of the 6 patients with bladder neck hypermobility was dry. Conclusions: Our results of silicone transurethral injection are disappointing but comparable to other bulking agents without a time dependent decrease in efficiency. The use of silicone micro-implants is an alternative for the treatment of intrinsic sphincter deficiency in patients without bladder neck hypermobility and in whom the sling procedure has failed.