CODE: 12.2 - Usage of collagen matrix (Pelvicol - BARD) in the treatment of stress urinary incontinence (SUI) short - term results
Article published in Urologia Polska 2006/59/Suplement 1.
Mariusz Blewniewski, Michał Markowski, Waldemar Różański
- II Klinika Urologii UM, WSS im. M. Kopernika w Łodzi
- Introduction. In urogynaecology, different synthetic and biological materials are used in treatment of stress urinary incontinence. The materials are creating the matrix for connective tissue. Among the biological materials it is important to point at xenogenic materials with Pelvicol as the representative. It is a complex of non cell collagen with elastine fibres, which is obtained for swine skin.
- Objectives. The objective of this study is to estimate the effectiveness of treatment in female urethra suspension with Pelvicol in stress urinary incontinence.
- Materials and methods. There were 21 female patients with stress urinary incontinence from October 2004 to January 2006, who were treated with surgical procedure - urethra suspension with a Pelvicol. In 15 cases the diagnosis stress urinary incontinence was confirmed, in 6 cases due to urodynamics study mixed urinary incontinence was diagnosed. In all cases it was second degree of stress urinary incontinence without prolaps. In 6 cases it was a second surgical procedure because of stress urinary incontinence. The age of patients was from 55 to 80 (median 68) years. Pretreatment evaluation consist of patient history - questionnaire (IIQ-7, UDI-6, VAS), vaginal examination (cough test, Bonney test), USG of urinary tract, measurement of vesico - urethralis back angle and Body Mass Index (BMI). Average time of surgical procedure was 20 minutes, hospital stay 2 days. Time of follow up was form 1 to 12 months. Patients were examined during follow up in 1, 3, 6 and 12 months after procedure. Quality of life was estimated by using VAS scale. Process of healing of postoperative wound was also examined.
- Results. The surgical procedure was generally well tolerated. There was no serious intra- or postoperative complications such as urethra, bladder or blood vessels lesion. After the procedure all patients were given some disinfecting drugs as a preventive treatment. Complete cure was in 18 cases (85.7%). Improvement was reach in other 3 cases (14.3%). Urge symptoms were observed directly after the procedure in 5 cases (23.8%). After anticholinergic treatment symptoms were no longer observed. One patient with mixed incontinence has to take drugs for longer period of time. In one case was urinary retention after micturition (about 200 ml). In that case there was a need to put a catheter into bladder for a short time. All patients using VAS scale objectively and definitely confirmed a great improvement in their quality of life. One patient reported slight involuntary loss of urine after getting up.
- Conclusions. Results of this study allow to say that treatment in stress urinary incontinence with usage of Pelvicol is small-invasive, safe procedure which is also effective in recurrent cases. Small-invasivness of this method allow to shorten a hospital stay and make a possibility of fast recovery. Because of the small group of patients and short time of observation this method needs further research.