Patient characteristics that may influence the effect of urethral injection therapy in female stress urinary incontinence.

Urethral injection therapy is a well-known treatment of female stress urinary incontinence, but the optimal group of recipients has not been established. This study aims at examining which patient characteristics are associated with success after urethral injection therapy.

This study is a post hoc analysis of a previously published randomized, 33-center study of the hydrogel bulking agent Bulkamid® vs the collagen gel Contigen®. Regardless of the treatment, women were considered cured if there were no stress incontinence episodes on the bladder diary and no stress incontinence symptoms on International Consultation on Incontinence Questionnaire Urinary Incontinence short form, improved if there was ≥50% reduction in stress incontinence episodes and no effect if there was <50% reduction in stress incontinence episodes one year after treatment.

Of the 345 women who were initially randomized, 291 women were included in this study. A total of 191 women received Bulkamid and 100 received Contigen. After one year, 74 (25%) were cured, 164 (56%) were improved and 53 (18%) had no effect. In a multivariate logistic regression analysis, age ≥60 years and <2.5 daily stress incontinence episodes were associated with cure. In this group, 90% had effect of the treatment and 38% were cured compared with a 13% cure-rate in women <60 years with ≥2.5 daily stress incontinence episodes.

Urethral injection therapy is more effective for the treatment of stress urinary incontinence in women ≥60 years with <2.5 daily stress incontinence episodes and has a 90% success-rate in these women.

The Journal of urology. 2019 Feb 15 [Epub ahead of print]

Marlene Elmelund, Eric R Sokol, Mickey M Karram, Roger Dmochowski, Niels Klarskov

Department of Obstetrics and Gynecology, Herlev and Gentofte Hospital, University of Copenhagen , Denmark., Departments of Obstetrics and Gynecology, Stanford University , Stanford , California., The Christ Hospital , Cincinnati , Ohio., Department of Urology, Vanderbilt University , Nashville , Tennessee.