Study compares urethral bulking agents at 1 year: recalcitrant stress urinary incontinence.(Gynecology)

HOLLYWOOD, FLA. -- The urethral bulking agent Uryx improved stress urinary incontinence comparably or better than Contigen 12 months after treatment in a multicenter study presented at the annual meeting of the American Urogynecologic Society.

"The study is part of the attempt to find that elusive perfect material for bulking," said Dr. Alfred Bent, chairman of the department of gynecology at Greater Baltimore Medical Center.

Injection of bulking agents into periurethral tissue is one strategy for managing female stress urinary incontinence. Uryx is a solution of ethylene vinyl alcohol copolymer dissolved in a dimethyl sulfoxide carrier; it is injected as a liquid and deploys as a soft, spongy mass. Genyx Medical Inc., makers of Uryx, sponsored the study. Contigen, manufactured by C.R. Bard, is an injectable form of collagen.

Uryx was injected using a 25G needle 2 cm distal to the bladder neck at a speed of 1 mL/60 sec.

"One thing is you don't always observe the bulking with Uryx because you're only injecting 1 mL at each site, so you don't see the immediate bulking you see with Contigen," he said.

Dr. Bent and his colleagues enrolled 244 women Who had failed previous incontinence therapy, including 46% who underwent surgery.

The mean age was 61, and the average duration of incontinence was 9.6 years. They were randomized in an approximate 2:1 ratio to either Uryx (174 patients) or Contigen (70 patients).