To evaluate the long-term outcomes of polydimethylsiloxane (Macroplastique® (MPQ) in women with stress urinary incontinence (SUI) secondary to intrinsic sphincter deficiency (ISD) using validated questionnaires.
Following IRB approval, charts of non-neurogenic women with SUI secondary to ISD who underwent MPQ injection were reviewed from a prospectively maintained database. ISD was defined as positive stress test with a well-supported urethra and low Valsalva leak point pressure (VLPP) when available. Excluded were women with follow-up <5 years. Baseline data included validated questionnaire scores (UDI-6 question 3 (0-3), VAS Quality of Life (QoL), Incontinence Impact Questionnaire (IIQ-7) and urodynamic study findings. Patients were followed with same questionnaires and three-dimensional ultrasound (3DUS) evaluating volume/configuration of MPQ. All 3DUS measurements were performed by the same imaging team blinded to clinical outcomes. Outcomes were evaluated in four groups based on prior SUI treatment. Success was defined as UDI-6 question 3 score of 0-1 and not requiring additional anti-incontinence therapy at the last visit after the last MPQ injection.
From April 2011-December 2016, 106 patients (median age 67) met study criteria. Median follow-up time was 7.4 years. Median MPQ injected was 5 ml. Overall success was 43%, with 54% successful after one injection and 46% requiring ≥2 injections. Across all groups, patients had improvement in QoL and IIQ-7 Question 7 (frustration). Among the failure group, 17% opted for a secondary autologous sling procedure.
MPQ demonstrated long-term favorable outcomes in a subset of women with SUI secondary to ISD.
Urology. 2024 Jan 08 [Epub ahead of print]
Samuel B Kusin, Timothy F Carrol, Feras Alhalabi, Alana L Christie, Philippe E Zimmern
Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9110. Electronic address: ., Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9110. Electronic address: ., Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9110. Electronic address: ., Simmons Comprehensive Cancer Center Biostatistics, University of Texas, Southwestern Medical Center, 6000 Harry Hines Blvd, Dallas, TX 75390-8852. Electronic address: ., Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9110. Electronic address: .