INJECTABLES FOR URETHRAL INCOMPETENCE

The failure to store urine secondary to bladder outflow incompetence requires a method of treatment to increase outflow resistance. The methods of injectable therapy as a modality to cause an additional resistance to the flow of urine are discussed. Results obtained with polytetrafluoroethylene (Polytef) and GAX-collagen (Contigen), presently under investigation, are presented. Excellent efficacy was attained for both substances: > 90% of women and 75% of men were rendered continent within two treatments. Concerns over particle migration reduce the utility of Polytef, especially in younger patients. Thus far, Contigen appears to be safe as well as efficacious. The best results for injectables were obtained in patients who did not have detrusor problems, had adequate bladder capacity, and showed no anatomic abnormality. Injectable techniques for the treatment of urinary incontinence were well tolerated by patients of all ages and reduced the need for major surgery. This modality of treatment should be added to the armamentarium of individuals involved in the management of urinary incontinence.