Document Detail


Glutaraldehyde cross-linked collagen in the treatment of urinary incontinence in children.
MedLine Citation:
PMID:  8558708     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Prospective analysis was done to assess the efficacy of glutaraldehyde cross-linked collagen in the treatment of pediatric structural urinary incontinence. MATERIALS AND METHODS: A total of 40 pediatric patients (average age 12.1 years) with structural urinary incontinence received 70 glutaraldehyde cross-linked collagen injections. Of the 40 patients 25 had spina bifida, 12 had the exstrophy/epispadias complex, 2 had continent reservoirs and 1 had bilateral ureteral ectopia. Average followup was 2.1 years (range 3 months to 6.3 years), and included urodynamic evaluation and assessment of change in continence grade, daily pad use and dry interval. Patient satisfaction was evaluated by questionnaire concerning self-esteem, activity level and patient assessment of overall benefit. RESULTS: Complete cure of incontinence was reported by 22% of patients, improvement by 54% and no change by 24%. There was statistically significant postoperative improvement of continence grade (exstrophy/epispadias p < or = 0.004, spina bifida p < or = 0.0001), decreased daily use of pads (exstrophy/epispadias p < or = 0.008, spina bifida p < or = 0.002) and dry interval (exstrophy/epispadias p < or = 0.008, spina bifida p < or = 0.004). Greater success occurred in cases of the exstrophy/epispadias complex (91%) than spina bifida (71%). No patient had unsafe bladder pressures as a result of collagen treatment. Reevaluation of a 1992 study group with an initial 88% cure or improvement rate showed that after a mean followup of 4.5 years the cure or improvement rate remained 86%. CONCLUSIONS: Collagen improves continence in the majority of children with anatomically based urinary incontinence. Exstrophy/epispadias patients have the best outcome from collagen treatment. Glutaraldehyde cross-linked collagen is durable in most patients who have an initially positive outcome.
Authors:
M D Bomalaski; D A Bloom; E J McGuire; A Panzl
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of urology     Volume:  155     ISSN:  0022-5347     ISO Abbreviation:  J. Urol.     Publication Date:  1996 Feb 
Date Detail:
Created Date:  1996-02-23     Completed Date:  1996-02-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  699-702     Citation Subset:  AIM; IM    
Affiliation:
Section of Urology, University of Michigan, Ann Arbor, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Child
Child, Preschool
Collagen*
Cross-Linking Reagents*
Female
Follow-Up Studies
Humans
Infant
Male
Prospective Studies
Urinary Incontinence, Stress / therapy*
Chemical
Reg. No./Substance:
0/Cross-Linking Reagents; 0/glutaraldehyde-cross-linked collagen; 9007-34-5/Collagen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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