Description

Collagen is a strong material found throughout your body in your bones, skin, and other tissues. The doctor will use animal or human collagen to help control your urine leakage.

The doctor injects collagen through a needle into the wall of your urethra, the tube that carries urine from your bladder. The collagen bulks up the urethral tissue and allows it to close up, stopping urine from leaking out of your bladder.

You may have a choice of three types of anesthesia (pain relief) for this procedure:

• Local anesthesia (only the area being worked on will be numb)
• Spinal anesthesia (you will be numb from the waist down)
• General anesthesia (you will be asleep and not able to feel pain)

After you are numb or asleep from your anesthesia, the doctor will put a medical device called a cystoscope into your urethra. The cystoscope allows your doctor to see the area.

Then your doctor passes a needle through your urethra to the sphincter muscle. Collagen is injected into the sphincter through this needle. The doctor can also inject collagen into the tissue next to the sphincter.

Collagen implants are usually done in the hospital, but they also may be done in your doctor's clinic. The procedure takes about 20 to 40 minutes.

Why the Procedure is Performed

Collagen implants can help both men and women.

Men who have urine leakage after prostate surgery may choose to have collagen implants.

Women who have urine leakage and want a simple procedure to control the problem may choose to have them. These women may not want to have surgery that requires general anesthesia.

Risks

Risks for this procedure are:

• Damage to the urethra or bladder
• Urine leakage may get worse
• Pain where the injection was done
• Allergic reaction to the collagen

Before the Procedure

Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.

You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin) warfarin (Coumadin), and any other drugs that make it hard for your blood to clot.

On the day of your procedure:

• You may be asked not to drink or eat anything for 6 to 12 hours before the procedure. This will depend on what type of anesthesia you will have.
• Take your drugs your doctor told you to take with a small sip of water.
• Your doctor or nurse will tell you when to arrive at the hospital or clinic.

After the Procedure

Most people can go home soon after the collagen injection. It may take up to a month before the injection fully works.

It may become harder to empty your bladder. You may need to use a catheter for a few days. These problems usually go away.

Outlook (Prognosis)

You may need 2 or 3 more injections to get good results. You usually need to have injections repeated every 6 to 18 months.

Collagen implants help most men who have had transurethral resection of the prostate (TURP). They help about half of men who have had their prostate gland removed to treat prostate cancer.

Alternative Names

Intrinsic sphincter deficiency repair; ISD repair

References

Wai CY. Surgical treatment for stress and urge urinary incontinence. Obstet Gynecol Clin North Am. 2009;36;509-519.

Dmochowski RR, Blaivas JM, Gormley EA, et al. Female Stress Urinary Incontinence Update Panel of the American Urological Association Education and Research, Inc, Whetter LE. Update of AUA Guideline on the surgical management of female stress urinary incontinence. J Urol. 2010;183:1906-1914.

Update Date: 1/13/2012

Reviewed by: Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.