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Abstract

Murless, in 1938, first reported on injection of sodium morrhuate around the urethra [1], and since then various materials have been injected for urinary incontinence as an alternative to surgery. Quackels [2] reported paraffin wax in 1955 and Sachse [3] used sclerosing agents in 1963. The initial results were poor and significant complications such as pulmonary emboli and urethral sloughing were seen. Polytetrafluoroethylene (Teflon) paste was first introduced by Berg [4] and then popularized by Politano [5] in the 1970s. Shortliffe et al. [6] published the first report on glutaraldehyde cross-linked collagen and more recently autologous fat injection [7] has been described. N ewer agents, such as silicone microparticles [8] and injectable microballoons, have also been reported [9].

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References

  1. Murless BC. The injection treatment of stress incontinence. J Obstet Gynaecol Br Emp 1938;45:67–73.

    Google Scholar 

  2. Quackels R. Deux incontinences après adénectomie guéries par injection de paraffine dans la périnée. Acta Urol Belg 1955;23:259–62.

    PubMed  CAS  Google Scholar 

  3. Sachse H. Treatment of urinary incontinence with sclerosing solutions. Indications, results, complications. Urol Int 1963;15:225–44.

    Article  PubMed  CAS  Google Scholar 

  4. Berg S. Polytef augmentation urethroplasty. Correction of surgically incurable urinary incontinence by injection technique. Arch Surg 1973;107:379–81.

    PubMed  CAS  Google Scholar 

  5. Politano VA, Small MP, Harper JM, Lynne CM. Periurethral Teflon injection for urinary incontinence. J Urol 1974;111:180–3.

    PubMed  CAS  Google Scholar 

  6. Shortliffe LMD, Freiha FS, Kessler R, Stamey TA, Constantinou CE. Treatment of urinary incontinence by the periurethral implantation of glutaraldehyde cross-linked collagen. J Urol 1989;141:538–41.

    PubMed  CAS  Google Scholar 

  7. Cervigni M, Panei M. Periurethral autologous fat injection for type III stress urinary incontinence. J Urol 1993;149 (Part 2):403A.

    Google Scholar 

  8. Harriss DR, Iacovou JW, Lemberger RJ. Peri-urethral silicone microimplants (Macroplastique7) for the treatment of genuine stress incontinence. Br J Urol 1996;78:722–8.

    PubMed  CAS  Google Scholar 

  9. Pycha A, Klingler CH, Haitel A, Heinz-Peer G, Marberger M. Implantable microballoons: An attractive alternative in the management of intrinsic sphincter deficiency. Eur Urol 1998;33:469–75.

    Article  PubMed  CAS  Google Scholar 

  10. McGuire EJ, Appell R. Transurethral collagen injection for urinary incontinence. Urology 1994;43:413–15.

    Article  PubMed  CAS  Google Scholar 

  11. Monga AK, Robinson D, Stanton SL. Periurethral collagen injections for genuine stress incontinence. Br J Urol 1995;76:156–60.

    PubMed  CAS  Google Scholar 

  12. Herschorn S, Radomski SB, Steele DJ. Early experience with intraurethral collagen injections for urinary incontinence. J Urol 1992;148:1797–800.

    PubMed  CAS  Google Scholar 

  13. Winters JC, Appell R. Periurethral injection of collagen in the treatment of intrinsic sphincter deficiency in the female patient. Urol Clin North Am 1995;22:673–8.

    PubMed  CAS  Google Scholar 

  14. Richardson TD, Kennelly MJ, Faerber GJ. Endoscopic injection of glutaraldehyde cross-linked collagen for the treatment of intrinsic deficiency in women. Urology 1995;46:378–81.

    Article  PubMed  CAS  Google Scholar 

  15. Eckford SD, Abrams P. Para-urethral collagen implantation for female stress incontinence. Br J Urol 1991;68:586–9.

    PubMed  CAS  Google Scholar 

  16. Appell RA. New developments: Injectables for urethral incompetence in women. Int Urogynecol J 1990;1:117–19.

    Article  Google Scholar 

  17. Khullar V, Cardozo LD, Abbott D, Anders K. GAX collagen in the treatment of urinary incontinence in elderly women: a two year follow up. Br J Obstet Gynaecol 1997;104:96–9.

    PubMed  CAS  Google Scholar 

  18. Kershen RT, Atala A. New advances in injectable therapies for the treatment of incontinence and vesicoureteral reflux. Urol Clin North Am 1999;26:81–94.

    PubMed  CAS  Google Scholar 

  19. Appell RA. Periurethral injection therapy. In: Walsh PC, Retik AB, Vaughan Jr ED, Wein AJ, editors. Cam pbell’s Urology, 7th edn. Philadelphia: WB Saunders, 1998; 1109–20.

    Google Scholar 

  20. McGuire EJ, Fitzpatrick CC, Wan J, Bloom D, Sanvordenker J, Ritchey M, Gormley EA. Clinical assessment of urethral sphincter function. J Urol 1993;150:1452–4.

    PubMed  CAS  Google Scholar 

  21. Raz S, Little N, Juma S. Female Urology. In: Walsh PC, Retik AB, Stamey TA, Vaughan ED, editors. Cam pbell’s Urology, 6th edn. Philadelphia: WB Saunders, 1992;2782–2828.

    Google Scholar 

  22. Faerber GJ. Endoscopic collagen injection therapy in elderly women with type I stress urinary incontinence. J Urol 1996;155:512–14.

    Article  PubMed  CAS  Google Scholar 

  23. Remacle M, Bertrand B, Eloy P, Marbaix E. The use of injectable collagen to correct velopharyngeal insufficiency. Laryngoscope 1990;100:269.

    Article  PubMed  CAS  Google Scholar 

  24. Stothers L, Goldenberg SL. Delayed hypersensitivity and systemic arthralgia following transurethral collagen injection for stress urinary incontinence. J Urol 1998;159:1507–9.

    Article  PubMed  CAS  Google Scholar 

  25. Carr LK, Herschorn S, Leonhardt C. Magnetic resonance imaging of intraurethral collagen injected for stress urinary incontinence. J Urol 1996;155:1253–5.

    Article  PubMed  CAS  Google Scholar 

  26. Stricker P, Haylen B. Injectable collagen for type III female stress incontinence: the first 50 Australian patients. Med J Australia 1993;158:89–91.

    PubMed  CAS  Google Scholar 

  27. Kieswetter H, Fischer M, Wöber L, Flamm J: Endoscopic implantation of collagen (GAX) for the treatment of urinary incontinence. Br J Urol 1992;69:22–5.

    Article  PubMed  CAS  Google Scholar 

  28. O’Connell HE, McGuire EJ, Aboseif S, Usui A. Transurethral collagen therapy in women. J Urol 1995;154:1463–5.

    Article  PubMed  CAS  Google Scholar 

  29. Moore KN, Chetner MP, Metcalfe JB, Griffiths DJ. Periurethral implantation of glutaraldehyde cross-linked collagen (contigen7) in women with type I or type III stress incontinence: quantitative outcome measures. Br J Urol 1995;75:359–63.

    PubMed  CAS  Google Scholar 

  30. Herschorn S, Radomski SB. Collagen injections for genuine stress urinary incontinence: Patient selection and durability. Int Urogynecol J 1997;8:18–24.

    Article  CAS  Google Scholar 

  31. Smith DN, Appell RA, Winters JC, Rackley RR. Collagen injection therapy for female intrinsic sphincteric deficiency. J Urol 1997;157:1275–8.

    Article  PubMed  CAS  Google Scholar 

  32. Swami S, Batista JE, Abrams P. Collagen for female genuine stress incontinence after a minimum 2-year follow-up. Br J Urol 1997;80:757–61.

    PubMed  CAS  Google Scholar 

  33. Cross CA, English SF, Cespedes RD, McGuire, EJ. A followup on transurethral collagen injection therapy for urinary incontinence. J Urol 1998;159:106–8.

    Article  PubMed  CAS  Google Scholar 

  34. Berman CJ, Kreder KJ. Comparative cost analysis of collagen injection and fascia lata sling cystourethropexy for the treatment of type III incontinence in women. J Urol 1997;157:122–4.

    Article  PubMed  CAS  Google Scholar 

  35. Sweat SW, Lightner DJ. Complications of sterile abscess formation and pulmonary embolism following periurethral bulking agents. J Urol 1999;161:93–6.

    Article  PubMed  CAS  Google Scholar 

  36. Stothers L, Goldenberg SL, Leone EF. Complications of periurethral collagen injection for stress urinary incontinence. J Urol 1998;159:806–7.

    Article  PubMed  CAS  Google Scholar 

  37. Elson ML. The role of skin testing in the use of collagen injectable materials. J Derml Surg Oncol 1986;15:301.

    Google Scholar 

  38. McClelland M, DeLustro F. Evaluation of antibody class in response to bovine collagen treatment in patients with urinary incontinence. J Urol 1996;155:2068–73.

    Article  PubMed  CAS  Google Scholar 

  39. Diagnostic and Therapeutic Technology Assessment (DATTA). Use of Teflon preparations for urinary incontinence and vesicoureteral reflux. J AMA 1993;269:2975–80.

    Google Scholar 

  40. Malizia AA, Reiman HM, Myers RP, Sande JR, Barham SS, Benson RC, Dewanjee MK, Utz WJ. Migration and granulomatous reaction after periurethral injection of Polytef (Teflon). J AMA 1983;251:3277–81.

    Google Scholar 

  41. Herschorn S, Glazer AA. Early experience with small volume periurethral teflon for female stress urinary incontinence. J Urol 2000;163:1838–42.

    Article  PubMed  CAS  Google Scholar 

  42. Politano VA. Periurethral polytetrafluoroethylene injection for urinary incontinence. J Urol 1982;127:439–442.

    PubMed  CAS  Google Scholar 

  43. Lim, KB, Ball AJ, Feneley RCL. Periurethral teflon injection: A simple treatment for urinary incontinence. Br J Urol 1983;55:208–10.

    PubMed  CAS  Google Scholar 

  44. Schulman CC, Simon J, Wespes E et al. Endoscopic injections of teflon to treat urinary incontinence in women. Br Med J 1984;288:192.

    CAS  Google Scholar 

  45. Deane AM, English P, Hehir M, Williams JP, Worth PHL. Teflon injection in stress incontinence. Br J Urol 1985;57:78–80.

    PubMed  CAS  Google Scholar 

  46. Beckingham IJ, Wemyss-Holden G, Lawrence WT. Longterm follow-up of women treated with perurethral Teflon injections for stress incontinence. Br J Urol 1992;69:580–3.

    PubMed  CAS  Google Scholar 

  47. Harrison SC, Brown C, O’Boyle PJ. Periurethral Teflon for stress urinary incontinence: medium-term results. Br J Urol 1993;71:25–7.

    PubMed  CAS  Google Scholar 

  48. Lotenfoe R, O’Kelly JK, Helal M, Lockhart JL. Periurethral polytetrafluoroethylene paste injection in incontinent female subjects: surgical indications and improved surgical technique. J Urol 1993;149:279–82.

    PubMed  CAS  Google Scholar 

  49. Lopez AE, Padron OF, Patsias G, Politano VA. Transurethral polytetrafluoroethylene injection in female patients with urinary incontinence. J Urol 1993;150:856–8.

    PubMed  CAS  Google Scholar 

  50. Vesey SG, Rivett A, O’Boyle PJ. Teflon injection in female stress incontinence. Effect on urethral pressue profile and flow rate. Br J Urol 1988;62:39–41.

    PubMed  CAS  Google Scholar 

  51. Claes H, Stroobants D, van Meerbeek J et al. Pulmonary migration following periurethral polytetrafluoroethylene injection for urinary incontinence. J Urol 1989;142:821–2.

    PubMed  CAS  Google Scholar 

  52. Mittleman RE, Marraccini JV. Pulmonary teflon granulomas following periurethral teflon injection for urinary incontinence. Arch Pathol Lab Med 1983;107:611–12.

    PubMed  CAS  Google Scholar 

  53. Kiilhoma, PJ, Chancellor MB, Makinen J, Hirsch IH, Klemi PJ. Complications of teflon injection for stress urinary incontinence. Neurourol Urodyn 1993;12:131–7.

    Article  Google Scholar 

  54. Stanisic TH, Jennings CE, Miller JI. Polytetrafluoroethylene injection for post-prostatectomy incontinence: experience with 20 patients during 3 years. J Urol 1991;146:1575–7.

    PubMed  CAS  Google Scholar 

  55. Dewan PA, Owen AJ, Byard RW. Long-term histologic response to subcutaneously injected Polytef and Bioplastique in a rat model. Br J Urol 1995;76:161–4.

    PubMed  CAS  Google Scholar 

  56. Billings E, May JW. Historical review and present status of free fat graft autotransplantation in plastic and reconstructive surgery. Plast Reconstr Surg 1989;83:368–81.

    Article  PubMed  Google Scholar 

  57. Horl HW, Feller AM, Bieuner E. Technique for liposuction fat re-implantation and long-term evaluation by magnetic resonance imaging. Ann Plast Surg 1991;26:248–58.

    Article  PubMed  CAS  Google Scholar 

  58. Bircoll M, Novack BH. Autologous fat transplantation employing liposuction techniques. Ann Plast Surg 1987;18:327–9.

    Article  PubMed  CAS  Google Scholar 

  59. Trockman BA, Leach GE. Surgical treatment of intrinsic urethral dysfunction: injectables (fat). Urol Clin North Am 1995;22:665–71.

    PubMed  CAS  Google Scholar 

  60. Su T-H, Wang K-G, Hsu C-Y et al. Periurethral fat injection in the treatment of recurrent genuine stress incontinence. J Urol 1998;159:411–14.

    Article  PubMed  CAS  Google Scholar 

  61. Santarosa RP, Blaivas JG. Periurethral injection of autologous fat for the treatment of sphincteric incontinence. J Urol 1994;151:607–11.

    PubMed  CAS  Google Scholar 

  62. Haab F, Zimmern PE, Leach GE. Urinary stress incontinence due to intrinsic sphincteric deficiency: experience with fat and collagen periurethral injections. J Urol 1997;157:1283–6.

    Article  PubMed  CAS  Google Scholar 

  63. Palma PC, Riccetto CL, Herrmann V, Netto NR Jr. Repeat lipoinjections for stress urinary incontinence. J Endourol 1997;11:67–70.

    PubMed  CAS  Google Scholar 

  64. Palma PC, Riccetto CL, Netto Jr NR. Urethral pseudolipoma: a complication of periurethral lipo-injection for stress urinary incontinence in a woman. J Urol 1996;155:646.

    Article  PubMed  CAS  Google Scholar 

  65. Currie I, Drutz HP, Beck J, Oxorn D. Adipose tissue and lipid droplet embolism following periurethral injection of autologous fat — case report and review of the literature. Int Urogynecol J 1997;8(6):377–80.

    Article  CAS  Google Scholar 

  66. Henly DR, Barrett DM, Weiland TL, O’Connor MK, Malizia AA, Wein AJ. Particulate silicone for use in periurethral injections: local tissue effects and search for migration. J Urol 1995;153: 2039–43.

    Article  PubMed  CAS  Google Scholar 

  67. Sherriff MKM, Foley S, McFarlane J, Nauth-Misir R, Shah PJR. Endoscopic correction of intractable stress incontinence with silicone micro-implants. Eur Urol 1997;32:284–8.

    Google Scholar 

  68. Koelbl H, Saz V, Doerfler D, Haeusler G, Sam C, Hanzal E. Transurethral injection of silicone microimplants for intrinsic sphincter deficiency. Obstet Gynecol 1998;92:332–6.

    Article  PubMed  CAS  Google Scholar 

  69. Radley SC, Chapple CR, Mitsogiannis IC, Glass KS. Transurethral implantation of Macroplastique® for the treatment of female stress urinary incontinence secondary to urethral sphincter deficiency. Eur Urol 2001;39:383–9.

    Article  PubMed  CAS  Google Scholar 

  70. Yoo JJ, Magliochetti M, Atala A. Detachable self-sealing membrane system for the endoscopic treatment of incontinence. J Urol 1997;158:1045–8.

    Article  PubMed  CAS  Google Scholar 

  71. Mayer R, Lightfoot M, Jung I. Preliminary evaluation of calcium hydroxylapatite as a transurethral bulking agent for stress urinary incontinence. Urology 2001;57:434–8.

    Article  PubMed  CAS  Google Scholar 

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Herschorn, S., Lee, P. (2003). Bulking Agents. In: Drutz, H.P., Herschorn, S., Diamant, N.E. (eds) Female Pelvic Medicine and Reconstructive Pelvic Surgery. Springer, London. https://doi.org/10.1007/1-84628-238-1_36

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  • DOI: https://doi.org/10.1007/1-84628-238-1_36

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