Treatment of stress urinary incontinence using polyacrylamide hydrogel in women after radiotherapy: 1-year follow-up

http://crossmark.crossref.org/dialog/?doi=10.1007/s00192-015-2834-2&domain=pdf

Web End = Int Urogynecol J (2016) 27:301305 DOI 10.1007/s00192-015-2834-2

http://crossmark.crossref.org/dialog/?doi=10.1007/s00192-015-2834-2&domain=pdf

Web End = http://crossmark.crossref.org/dialog/?doi=10.1007/s00192-015-2834-2&domain=pdf

Web End = http://crossmark.crossref.org/dialog/?doi=10.1007/s00192-015-2834-2&domain=pdf

Web End = http://crossmark.crossref.org/dialog/?doi=10.1007/s00192-015-2834-2&domain=pdf

Web End = http://crossmark.crossref.org/dialog/?doi=10.1007/s00192-015-2834-2&domain=pdf

Web End = http://crossmark.crossref.org/dialog/?doi=10.1007/s00192-015-2834-2&domain=pdf

Web End = http://crossmark.crossref.org/dialog/?doi=10.1007/s00192-015-2834-2&domain=pdf

Web End = ORIGINAL ARTICLE

Treatment of stress urinary incontinence using polyacrylamide hydrogel in women after radiotherapy: 1-year follow-up

Jan Krhut1 & Alois Martan2 & Michaela Jurakova3 & David Nemec1 &

Jaromir Masata2 & Peter Zvara4

Received: 27 May 2015 /Accepted: 18 August 2015 /Published online: 5 September 2015 # The International Urogynecological Association 2015

AbstractIntroduction and hypothesis Information on urethral bulking therapy in women after previous pelvic radiotherapy is lacking. This study compared the safety and efficacy of polyacryl-amide intraurethral injections in patients with and without previous radiotherapy.

Methods A total of 46 patients with severe stress urinary incontinence (SUI) were enrolled in this multicenter prospective trial. Group A consisted of 24 patients with previous radio-therapy to the pelvis for the treatment of a gynaecological malignancy. Group B consisted of 22 patients without previous radiotherapy. All patients were treated with a transurethral injection of a bulking solution (Bulkamid). The average follow-up was 12.4 months. The paired Wilcoxon test was used to compare the results before and after the procedure within the groups, and the two-sample Wilcoxon test was used for comparisons between groups.

Results Complete continence was achieved in 25 % of patients in group A and in 36.4 % of patients in group B. Significantly reduced urine leakage was observed in both groups (p=0.0164 in group A and p=0.0002 in group B).

The total scores in the International Consultation on Incontinence Questionnaire decreased by 5.2 in group A (p=0.0000) and 6.36 in group B (p=0.0001). The scores for the Total Patient Perception of Bladder Condition decreased by1.54 in group A (p=0.0001) and 2.59 in group B (p=0.0000), with a significant difference between groups (p=0.0224). No clinically significant changes in urodynamic parameters were observed. No severe adverse events were noted. Conclusions Based on our results, we conclude that urethral bulking therapy is a valuable treatment option in patients with severe SUI who have undergone pelvic radiotherapy for the treatment of gynaecological malignancy.

Keywords Pelvic radiotherapy . Polyacrylamide hydrogel . Stress urinary incontinence . Urethral bulking

Introduction

Radiotherapy,...