NEW YORK (Reuters Health) – Injection of Macroplastique (Uroplasty), a urethral bulking agent, can improve female stress urinary incontinence for at least two years, new research shows.

Exactly how urethral bulking agents work to improve urinary incontinence is unclear, but the mechanisms may include augmentation of “the urethral mucosa to improve coaptation and intrinsic sphincter deficiency, and…pressure transmission to the proximal urethra by producing focal, firm expansion of tissue surrounding the urethra,” according to the report in the April issue of The Journal of Urology.

The authors had previously reported their 12-month results with Macroplastique compared to collagen injection for intrinsic sphincter deficiency, which had shown Macroplastique to be significantly more effective, with a 12% cure rate difference (36.9% vs 24.8%).

Their current paper reports the 24-month outcomes in 67 of the 75 women who had improvements of at least 1 Stamey grade at the one-year evaluation. (The other 8 women withdrew from the study.)

Fifty-six of the 67 (84%) had sustained success at 24 months, Dr. Gamal Ghoniem, from the Cleveland Clinic Florida, Weston, and colleagues note.

Forty-five women (67%) were dry (Stamey grade 0), including 33 of 38 who were dry at 12 months. In addition, 12 of 29 women who were “improved” at 12 months were dry at 2 years.

Overall scores and subscale scores on the Incontinence Quality of Life questionnaire improved significantly from baseline (p < 0.001), the report indicates. Average pad weight had fallen from 24 g at baseline to 4 g at 12 and 24 months. Based on patient and physician assessments, 85% of subjects were dry or markedly improved 24 months following Macroplastique injection. “Macroplastique should now be considered a reasonable first choice for urethral bulking due to its superiority over collagen and sustained efficacy during 2 years,” the authors conclude. Reference:
J Urol 2010;183:1444-1449.