Transurethral injection of silicone microimplants for intrinsic urethral sphincter deficiency

Abstract

Objective: To assess the short-term efficacy of transurethral injection of silicone microimplants in women with intrinsic sphincter deficiency. Methods: During January 1995 and December 1996, 32 women (mean age 64.3 years, range 39–85 years) with type III stress incontinence (intrinsic sphincter deficiency) underwent transurethral injection of silicone microimplants under general anesthesia. Twenty-eight had undergone previous continence surgery. Subjective and urodynamic assessments were made at 6 and 12 months after injection to evaluate success and short-term effects. Results: Objective and subjective success rates were 75% and 59% at 6 and 12 months, respectively. Injections of silicone microimplants significantly increased maximum urethral closure pressure (maximum urethral pressure at rest: 34.40 ± 16.46 cm H₂O, 95% confidence interval [CI] 28.55, 40.25 versus 25.35 ± 10.78 cm H₂O, 95% CI 21.52, 29.18; P = .027). There were no complications after surgery up to 1 year. Conclusion: Transurethral silicone injections were effective in 60% of cases of intrinsic sphincter deficiency, although there was a time-dependent decrease.