Transurethral Injection of Bulking Agents
Collagen
This is an office procedure that is done under local anesthetic and you can drive back home. It takes about 30 minutes. Some of the bulking agents as collagen require a skin test prior to the procedure to determine if you are allergic to it as collagen.
Dr. Aboseif has an extensive experience in the transurethral injection of various bulking agents and has published one of the original articles on collagen in women with incontinence.
Transurethral collagen therapy in women. O’Connell HE, McGuire EJ, Aboseif S, Usui A. J Urol. 1995 Oct;154(4):1463-5.
Collagen is the most common bulking agent used. It is a biologic substance that comes in a paste form and can be easily injected into body tissue and accepted by those tissues. Several other bulking agents as Duraspheres and Coaptite have been recently introduced into the market. Dr. Aboseif have been involved in new experimental bulking agents called Bulkimad with encouraging results.
Concept of bulking agents:
Enhance the shut-off valve of the urethra (the sphincter) to work more efficiently
Procedure:
Preparation for Collagen: There is no special preparation for collagen injection, however, you need to tell Dr. Aboseif and his staff if you are taking any medication, especially blood thinners as Coumadin, aspirin, iboprofen or you have any prosthetic in your body as this may require the use of prophylactic antibiotics prior to the procedure.
The procedure will be performed in the office under local anesthetic. You will be placed on the table in stirrups. Topical anesthetic (lidocaine) is introduced to numb and lubricate the urethra prior to the procedure
A very special cystoscope (a small thin telescope-like tube with a light and tiny camera attached) with a very delicate needle is slowly inserted into th
e urethra to the bladder. The camera attached to the cystoscope will allow you to see the images on a monitor. A sterile liquid is introduced into the bladder to improve the view of the bladder wall. As the bladder fills you may experience an uncomfortable urge to urinate, please let Dr. Aboseif knows and he will empty the bladder. Using a very delicate needle, local anesthetic (Lidocaine) is first injected into the walls of the urethra at the level of the bladder neck to numb the tissues and make the procedure very comfortable followed by the injection of the collagen. This causes coaptation of the urethral wall and the bladder opening and increases the resistance preventing urine from leaking out.
If the procedure is successful in improving your incontinence, you may need repeated injections over time to maintain continence as the collagen is gradually absorbed by the body.
Possible risks of Collagen Injection
You may experience mild burning during urination and some blood in the urine for few hours to 1-2 days after the procedure. These usually resolve spontenously. Rare complications include excessive bleeding, fever, chills, severe pain and difficult urination. If this happens, please contact Dr. Aboseif’s office or go the emergency room.
