Korean J Urol.  2014 Mar;55(3):182-189. 10.4111/kju.2014.55.3.182.

Treatment Outcomes of Transurethral Macroplastique Injection for Postprostatectomy Incontinence

• Lee SW
• Kang JH
• Sung HH
• Jeong US
• Lee YS
• Baek M
• Lee KS

• KMID: 1988422
• DOI: http://doi.org/10.4111/kju.2014.55.3.182

Abstract

PURPOSE
We investigated the efficacy of transurethral injection of Macroplastique bulking agent (Uroplasty) for male stress urinary incontinence (SUI) after prostate surgery.
MATERIALS AND METHODS
This retrospective review included men with SUI treated by transurethral injection for symptoms resulting from prostate surgery. Patients were evaluated at 1 month and 6 months after injection by determining the number of pads used per day and changes in incontinence symptoms. Treatment success was defined as use of 1 pad or fewer per day combined with subjective symptom improvement.
RESULTS
The study population comprised 30 men with a mean age of 66.1+/-5.3 years. Of the 30 patients, 24 (80.0%) underwent prostate cancer surgery and the remaining 6 (20.0%) underwent surgery for benign prostatic hyperplasia. The preinjection pad number was 2.9+/-1.9 pads per day. After injection treatment, the mean follow-up period was 9.3+/-12.7 months and the success rate was 43% (13/30) at 1 month and 32% (6/19) at 6 months. Injection was more likely to result in a successful outcome in patients with no preinjection radiation treatment history and higher abdominal leak point pressure (ALPP) than in those with a previous history of radiation treatment and lower ALPP, although this result was not statistically significant. Acute urinary retention occurred in 5 patients (17%).
CONCLUSIONS
Transurethral Macroplastique injection treatment is a relatively non-invasive treatment method for male SUI with a success rate of 43% at 1 month and 32% at 6 months. Patients with a higher ALPP and no previous history of radiation therapy may experience better treatment outcomes.

Keyword

Dimethylpolysiloxanes; Male; Prostate; Urethra; Urinary incontinence

MeSH Terms

Dimethylpolysiloxanes
Follow-Up Studies
Humans
Male
Methods
Prostate
Prostatic Hyperplasia
Prostatic Neoplasms
Retrospective Studies
Urethra
Urinary Incontinence
Urinary Retention
Dimethylpolysiloxanes

Figure

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  FIG. 1 Pre- and postinjection state of the urethral sphincter. (A) Preinjection state. The urethral lumen is wide open. (B) Postinjection state. The urethral lumen is coaptated.

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  FIG. 2 Benefit and satisfaction measurements for transurethral injection treatment. (A) Fifteen patients (50%) benefitted from the treatment and 13 patients (43%) reported much benefit. (B) Fifteen patients (50%) were also satisfied with the treatment, whereas only five patients (17%) were "very dissatisfied."

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