Joseph K. Izes, William Bihrle III, Richard Bihrle
Accepted 14 February 1997.
Periurethral injection of glutaraldehyde cross-linked collagen is a well-established modality for the treatment of patients with incontinence caused by structural defects at the bladder outlet. Little is known about the potential usefulness of this approach to the nonfunctioning continence mechanism of a leaking continent urinary reservoir. An animal model of an incontinent Indiana reservoir was created using the naturally incompetent canine ileocecal valve. The effectiveness and feasibility of endoscopic submucosal injection of glutaraldehyde cross-linked collagen into the ileocecal valve to increase resistance were examined.
Materials and Methods
Seven beagle dogs underwent isolation of the ileocecal segment. The right colon and ileum were brought to the skin as 2 stomas. Baseline leak point pressures of the ileocecal valve were determined while infusing contrast material into the right colon. The leak point was observed fluoroscopically, and the pressure at which contrast material crossed the valve was measured. Glutaraldehyde cross-linked collagen, 4 to 10 ml., was injected endoscopically into the valve in a circumferential pattern. Leak point pressures were measured immediately, 1 month after injection and 3 months after injection.
An average of 7.1 gm. (range, 4.1 to 10.1 gm.) was required to create an endoscopically “closed” ileocecal valve. Leak point pressure increased from a mean 3.8 mm. water (range, 2.5 to 6.0 mm. water) at baseline to mean 35.7 mm. water after injection (range, 22.0 to 57.0 mm. water). At 1 month, mean leak point pressure decreased slightly to 26.7 mm. water. This pressure stabilized at 3 months at 29.5 mm. water.
Endoscopic delivery of glutaraldehyde cross-linked collagen into the ileocecal valve consistently enhanced resistance as measured by leak point pressure. This effect was durable over a 3-month period of observation. Admittedly, this period of observation is relatively short. Longer followup may have demonstrated significant diminution of collagen migration or resorption. However, this feasibility study demonstrates that collagen injections may provide a minimally invasive means of treating the incontinent urinary reservoir.

Report post

3 replies. Join the discussion

Hi can any one tell me about this if this works . thanks Frank

Report post

This one is going to require one of our trained medical personnel just to interpret! Sorry I could not be of help.

Report post

My Mother-in-Law has had the collagen injections for incontinence and it is successful for a few months and then they have had to do it again..She is 95 yrs old.They did it about a year ago and then again a few months ago..She did have success.

She has not had her bladder removed...


Report post

This discussion is closed to replies. We close all discussions after 90 days.

If there's something you'd like to discuss, click below to start a new discussion.

Things you can do

Support BCAN

Help the Bladder Cancer Advocacy Network reach its goals and support people like yourself by making a donation today.

Donate to the Bladder Cancer Advocacy Network

Discussion topics

Walk for Bladder Cancer May 3rd

Walk for Bladder Cancer

Resources from BCAN

BCAN on Facebook

Like the Bladder Cancer Advocacy Network on Facebook

Community leaders