Effectiveness of Periurethral Injection on Stress Urinary Incontinence

Objective: To determine one-year subjective and objective evaluation results of penurethral injection (PUT) applied to women suffering from stress urinary incontinence (SUI). Material and Methods: Twenty five patients with complaints of SUI have participated in our study. Preoperative and postoperative results of urinalysis, stress and Q-tip tests, post voiding residual volumes (RV) and survey of incontinence quality of life (I-QOL) criteria were recorded. Later on, Urodex (R) (Cross- linked hyaluronic acid, detxranomere) was injected to them. The cases were monitored at regular intervals for a mean of 14 +/- 5.84 months. Results: Eighteen (72%) out of all cases were encountered during menopausal period. Eight of the patients had previous gynecologic operations. Mean age was 53.97 +/- 13.01 years. Mean application period of PUT was 6.95 +/- 1.46 minutes. Differences between the preoperative and postoperative results of RV and I-QOL were not statistically significant. From subjective success point of view; 17 (68%) of the patients claimed no change on their incontinence problem, two (8%) of the patients claimed that their conditions were slightly improved, and six (24%) of the patients claimed that their conditions significantly improved. When objective success is considered, there was success in seven (28%) patients, and failure in 18 (72%) patients. Conclusion: PUT is a minimally invasive treatment method used in all types of SUI. PUI treatment might be preferred for the old, obese patients with additional health problems, having incontinence dependent on hypermobility at which the open surgery incurs a great risk. However, as the new techniques are not readily available, a periurethral injection technique may still be a valid choice in patients who have poor surgical risks, and to whom the low success rate has been adequately explained.