Abstract
Continuous advancements in materials technology have provided the possibility that multiple new urethral bulking agents will be available soon. Experience continues to accrue in clinical trials for urethral bulking with these agents. Parallel use for the indication of pediatric vesicourethral reflux also has provided evidence of biologic activity related to these compounds. All of the agents closest to complete analysis are synthetic and represent a variety of material types and characteristics. As these materials evolve, understanding of the preferential injection technique is being gained. Delivery methods and sites may prove to alter the biologic activity of these compounds substantially. Emphasis on other minimally invasive options for the surgical treatment of stress incontinence also has resulted in the development of radiofrequency vesicourethral suspension. Improved understanding of thermal application to tissue, acute and chronic tissue response to this application, and accumulating human experience with this method of therapy has provided an acceptable tolerability profile for this therapy. This profile may provide application of this method of therapy to an in-office treatment setting, precluding hospitalization and substantially decreasing convalescence times.
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Ritts RE: Particle migration after transurethral injection of carbon coated beads. J Urol 2002, 167:1804–1805.
Dmochowski R, Appell RA, Klimberg I, Mayer R: Initial clinical results from Coaptite injection for stress urinary incontinence, comparative clinical study. Presented at the International Continence Society. Heidelberg, Germany: August 27, 2002.
Caione P, Capozza N: Endoscopic treatment of urinary incontinence in pediatric patients: 2-year experience with dextranomer/hyaluronic acid. J Urol 2002, 168:1868–1871.
Peeker R, Edlund C, Wennberg AL, Fall M: The treatment of sphincter incontinence with periurethral silicone implant (macroplastique). Scand J Urol Nephrol 2002, 36:194–198.
Dmochowski RR, Herschorn S, Corcos J, et al.: Multicenter randomized controlled study to evaluate Uryx urethral bulking agent in treating female stress urinary incontinence. J Urol 2002, 167:LB-L10.
Aboutaleb H, Bolduc S, Upadhyay J, et al.: Subureteral polydimethylsiloxane injection versus extravesical reimplantation for primary low grade vesicoureteral reflux in children: a comparative study. J Urol 2002, 169:313–316.
Hecht P, Hayashi K, Lu Y, et al.: Monopolar radiofrequency energy effects on joint capsular tissue: potential treatment for joint instability: an in vivo mechanical, morphological, and biochemical study using an ovine model. Am J Sports Med 1999, 27:761–771.
Galen DL: Histologic results of a new treatment for stress urinary incontinence without implantable materials. Obstet Gynecol 2000, 95:S30. Rabbit-based model emphasizing the reproducible effects of RF energy on the endopelvic fascia and the lack of visceral injury induced by this thermal application.
Dmochowski RR, Avon M, Ross J, et al.: Transvaginal radiofrequency treatment of the endopelvic fascia: a prospective evaluation for the treatment of genuine stress urinary incontinence. J Urol 2003, 169:1028–1032. First analysis of TV RF energy delivery and its effect on symptomatic stress urinary incontinence.
Fulmer BR, Sakamoto K, Turk TM, et al.: Acute and long-term outcomes of radio frequency bladder neck suspension. J Urol 2002, 167:141–145. Well-designed study reporting the first large-scale RF experience in humans using the laparoscopic RF treatment approach.
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Dmochowski, R., Appell, R.A. Advancements in minimally invasive treatments for female stress urinary incontinence: Radiofrequency and bulking agents. Curr Urol Rep 4, 350–355 (2003). https://doi.org/10.1007/s11934-003-0005-3
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DOI: https://doi.org/10.1007/s11934-003-0005-3