Collagen Injections Can Halt Stress Incontinence

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May 3, 2000 (Atlanta) -- Collagen injections appear to be a good option for women who suffer from severe stress incontinence but don't want to have corrective surgery.

Stress incontinence is the sudden leakage of urine caused by physical activities that put stress on the abdomen. In a study of 55 women with this problem, researchers from Kumatoma University in Japan found that injecting collagen protein on both sides of the urethra relieved symptoms in about two-thirds of the patients for longer than a year.

This type of incontinence can be triggered by running, coughing, sneezing, even laughing. Most sufferers are women, and many are forced to wear diaper-like pads to control this common but embarrassing problem.

As women get older, the muscles surrounding the female organs weaken as a result of aging and of stretching during childbirth. The urethra, the opening by which urine leaves the body, also weakens. Both these conditions can lead to stress incontinence.

Collagen injections, a relatively simple and inexpensive outpatient procedure, were especially effective for patients over 65, the researchers say. Women who got the collagen shots received a local anesthetic and were done in less than an hour. Even after two years, the success rate for the injections was almost 60%, the researchers say.

Collagen is a natural protein that forms connective tissues in the body. The collagen used in the injections is taken from cattle.

In the United States, collagen injections to beef up the deteriorating muscles that support the urethra in patients with stress incontinence have been around since the early '90s. But surgery that builds a "sling" of supportive tissue under the urethra is generally the treatment of choice here.

Patients in Japan say they prefer the collagen treatment first, Masaki Yoshida, MD, PhD, one of the study's investigators, tells WebMD. If the shots fail after two or three tries, surgery is the logical next step, he says. Yoshida and his colleagues presented their results at a meeting of the American Urological Association here this week.

The Japanese scientists acknowledge many patients had some minor complications after the collagen procedure, such as problems with urination or too-frequent urination. But Yoshida says those generally went away within a couple of days. Before getting the treatments, patients must be screened for allergies because they receive a bovine serum as part of their injections.

If collagen works so well in Japan, why isn't it used more often here? The answer appears to be that the operation's success rate is higher -- perhaps as high as 85%. And the fix lasts much longer.

"For someone's who's young, with a long life expectancy, it's better to go ahead and do a definitive surgery," Edward King, MD, a urologic surgeon from Ocala, Fla., tells WebMD. King says he would only consider the injections for patients who declined to have the operation or whose health was too poor to tolerate surgery.

Vital Information:

  • Among women with stress incontinence, collagen injections relieve symptoms in about two-thirds of patients for more than a year.
  • The collagen shots can be given under local anesthesia, and the procedure takes less than an hour.
  • Younger women who have stress incontinence may choose to have surgery instead, because the success rate is much higher and the relief of symptoms lasts longer.
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