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Injectable Biological bulking Agent to Treat Stress Urinary Incontinence in Women: A Feasibility Pilot Study

Open Journal of Urology 2022年第2期12卷 107-116页

作者： Salvador V. C. Lima Eugê nio S. Lustosa Fernanda C. F. S. Calisto Evandilson G. C. De Barros Bruno C. A. Santos Fábio O. Vilar Post-Graduation Program in Surgery Department of Surgery Health Sciences Center Federal University of Pernambuco Recife Brazil Department of Surgery Center for Health Sciences Federal University of Pernambuco Recife Brazil Head of Urology Department Federal University of Pernambuco Recife Brazil

Background: Urinary incontinence mainly affects women regardless of age and, as it affects their quality of life, influences work, sex life and independence for activities of daily living. The treatment of stress urinary incontinence including urethral volume injection therapy can provide an intermediate option over non-surgical and surgical therapies. One of the mechanisms for stress continence depends on the effective coaptation of the urethra during the increase in intra-abdominal pressure. The bulking agents can be injected transurethral or periurethral retrogradely, using direct vision from a cystoscope. Purpose: To evaluate the feasibility and preliminary outcome performance of the bacterial polysaccharide gel used as biological bulking agent applied in female patients with stress urinary incontinence. Methods: A prospective clinical pilot study was performed, in a single institution, including female patients who were admitted to the urologic outpatient clinic with Stress Urinary Incontinence (SUI) without previous treatments and they were selected and underwent bulking agent procedure. The evaluation was performed at the time of enrollment and 6 months after treatment. The primary outcome was Quality of Life (QOL) using the ICIQ-SF Questionnaire. The amount of urine leakage measured by the 1-HOUR PAD-TEST was the second outcome. Results: Fifteen women (with an average age of 53 years) were submitted to the application of bacterial cellulose gel and she was analyzed. Only two patients presented unchanged incontinence. The study considered as primary outcome the improvement or disappearance of symptoms after six months of intervention. Post-intervention Quality of Life (QOL) questionnaire indicated that all of these patients related a better quality of life (62.5%). Through the PAD-test it was possible to observe a decrease in urinary leak of 85% comparing the results pre and post-intervention (BCA—Bacterial Cellulose Application) with p-value equal to 0.00000

关键词： bulking agents Urinary Incontinence Stress Biopolymers

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Internal anal sphincter augmentation and substitution

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Gastroenterology Report 2014年第2期2卷 106-111页

作者： Fernando de la Portilla Unidad de Gestion Clinica de Cirugia General y del Aparato Digestivo Instituto de Biomedicina de Sevilla(IBIS)SevilleSpain

There is an increasing recognition of the importance of internal anal sphincter(IAS)dysfunction presenting as passive faecal *** problem may manifest after anal sphincterotomy or following the more minimally invasive operations for haemorrhoids,as well as with advancing *** of the poor results of IAS plication and the beneficial outcomes with peri-urethral bulking agents in urology,these materials have been developed for use in IAS *** review outlines the basic purported mechanisms of action,defining the materials in clinical use,their methods of deployment,complications and reported *** is still much that is unknown concerning the ideal agent or the volume and the technique of deployment,which will only be answered by powerful,prospective,randomized,controlled *** specific role of autologous stem cells designed to regenerate the sphincters in cases of functional impairment or muscle loss is yet to be seen.

关键词： faecal incontinence internal anal sphincter dysfunction internal anal sphincter augmentation bulking agents

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