Treatment of Post-Prostatectomy Stress Urinary Incontinence with Periurethral Polytetrafluoroethylene Paste Injection

Publisher Website
Google Scholar
Abstract
Periurethral injection of polytetrafluoroethylene (Teflon) paste was performed to treat moderate to severe stress urinary incontinence following prostatectomy. A total of 20 procedures was performed in 13 men, of whom 8 had previously undergone radical prostatectomy for prostate cancer and 5 had undergone transurethral electrocautery resection of the prostate for bladder outlet obstruction due to benign prostatic hyperplasia. All patients had significant stress urinary incontinence requiring a minimum of 2 pads wet daily. Between 16 and 20 cc polytetrafluoroethylene paste were injected initially transurethrally into the periurethral tissues in the region of the external sphincter. Of the 13 patients 7 underwent a second injection procedure with an additional 12 to 23 cc paste. Three men (23%) experienced a noticeable improvement in continence status, including 1 of 5 patients after transurethral electrocautery resection and 2 of 8 after radical prostatectomy. However, none of these men became completely dry or was able to eliminate completely the use of pads. Of the 13 patients 10 (77%) experienced no detectable improvement in continence status. Seven patients have now successfully undergone implantation of an artificial urinary sphincter without complication. With a minimum followup of 11 months in all patients and a maximum followup of 3 years, none has experienced any clinically detectable long-term side effects related to the polytetrafluoroethylene injection or evidence of particulate migration.