The urodynamic study showed that I can retain only 30cm of water. I understand the norm is 90 to 100cm. The doctor prescribed RONDEC-TR8-120. I received the generic CARBINOX/PSE8-120 taking one pill twice a day. In one week I cannot really see any improvement with this medication and it makes me drowsy.
I had kidney stones 1-1/2 years ago that plugged the ureter and gave me a serious blood infection so I am very sensitive to trying to keep my kidneys purged.
It appears to me that I am faced with some sort of surgical solution.
The urologist suggested a collagen implant and I started a 4 week allergy test for it. What are the negative side affects of collagen?
I have been all over the Net trying to find information on this but find very little. It appears that the collagen is not as permanent as a sling but also not as invasive and perhaps not as risky. Apparently the collagen can be allowed to be absorbed if I decide to try a sling later which, depending upon how it is obtained and installed, can be significant surgery in itself.
Please advise about the collagen success and side effects compared to a sling. Thanks in advance.
Collagen injections (Contigen) range in efficacy from about 50% to 80% success rate. Slings are probably more effective overall but in the range of 75-85%. Both of the procedures depend upon the experience of the doctor doing the procedure so be sure to find someone who has done more than a dozen or so. I have included the following abstracts that might be helpful.
Abstracts
Transurethral collagen injection for female stress incontinence.
Elsergany R, Elgamasy AN, Ghoniem GM
Tulane University School of Medicine, New Orleans, Louisiana 70112, USA.
Int Urogynecol J Pelvic Floor Dysfunct 1998;9(1):13-8
Periurethral collagen injections have been used to treat female urinary incontinence secondary to intrinsic sphincteric deficiency (ISD). As an alternative, a transurethral submucosal collagen injection was used in 33 consecutive women suffering from stress incontinence secondary to ISD at Tulane University Medical Center.
Prior to the procedure, careful clinical examination with a videofluorourodynamic study was performed for each case. The procedure was carried out under local anesthesia assisted with monitored anesthesia care (MAC). The collagen was injected transurethrally by the long collagen needle (C. R. Bard). In the first 11 cases the average cumulative collagen injected per patient was 6.1 ml, whereas in the last 22 cases the average was 3.5 ml. As a result of the injection 16 patients were dry (48.5%) and 11 were improved (33.3%), with an overall success rate of 81.8%. The injection failed in 6 patients (18.1%). The mean follow-up was 18.8 months, with a range of 2-33 months.
In the successful group there was a significant decrease in pretreatment frequency, from an average of 8 to 4.9 (P = 0.005) and in nocturia from an average of 2.14 to 0.76 (P = 0.001).
Also, there was a significant decrease in the number of pads, from an average of 3.7 to 1.1 (P = 0.001). The stress leak-point pressure showed a significant increase, from an average of 68.1 to 93.5 cm H2O (P = 0.03). There was no relation between grade of incontinence and the success of the injection. Two cases suffered from temporary urinary retention.
This study revealed that the transurethral submucosal collagen injection is an effective method for treating cases of intrinsic sphincteric deficiency. The volume of collagen required to produce the seal effect is small and it may decrease the reinjection rate. As experience is gained, the procedure time is typically 15 minutes.
This makes it a reliable, cost-effective and well-controlled method. However, it has a learning curve and the cystoscope instruments require minor adaptation for its use.
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