요도괄약근 기능부전에 의한 요실금 환자에서 경요도 Collagen 주입 요법
Collagen Injection Therapy in Urinary Incontinence with ISD (Intrinsic Sphincter Deficiency)
양승하, 박흠례,
소속 상세정보
양승하 ( )
고려대학교 의과대학 비뇨기과학교실
박흠례 ( )
고려대학교 의과대학 비뇨기과학교실
KMID : 0358319970380090985
Abstract
결론
요도괄약근기능 저하에 대한 요도점막하 collagen주입치료 결과 46%에서 요실금이 소실
되었고, 36%에서는 증상이 호전되어 전체적으로 82%의 성공률을 나타내었다. Collagen 주
사는 내요도괄약근 기능부전을 동반한 여성의 복압성 요실금에서는 매우 효과적이었으며 ,
과거력상 수술에 의해 방광경부의 섬유화나 요도주위조직의 위축소견이 관찰되거나 남성에
서는 성공률이 감소하는 것으로 생각된다.
#초록#
Bovine collagen (ContigenR, Bard Inc.) injection has been used for
treating urinary incontinence caused by intrinsic sphincter deficiency (ISD) with
relatively high success rate and fewer complication.
Retrospective analysis was made for 11 urinary incontinent patients who have
undergone collagen injection. Of the total, stress urinary incontinence (SUI) associated
with ISD were noted in six, myelodysplasia in one, short bladder neck in one, cauda
equina syndrome in one and, two with pelvic bone fracture. Average duration of
symptoms was 10.8 years. Four patients had history of failed surgery to correct
incontinence (two with Raz operations and two with plication of bladder neck).
Transurethral injections of 4∼12 ml of collagen were made at 4 and 8 o'clock position
of the bladder neck with the bevelled portion of needle facing the urethral lumen.
After the first injection, cure and improvement of incontinence were noted in 3 (SUI)
and 6 (3 with SUI, 1 with short bladder neck, 1 with myelodysplasia and 1 with pelvic
bone fracture) respectively. After the repeated injection for 3 patients who had improved
after first injection, all became dry. At 13 months of follow-up, total success rate was
82% (5 with cure and S with improvement of the incontinence). Two patients who
showed failure were all males with periurethral scar formation. Collagen injection seemed
an effective therapeutic method in female SUI with ISD or myelodysplasia provided
repeated injection is to be made However, it was suggested that the male patients or
one with extensive scar formation were not good candidate for injection therapy.
키워드
Collagen injection; Intrinsic sphincter deficiency; Stress urinary incontinence;
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