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Men who have problems with urinary incontinence after radical prostatectomy may benefit from collagen injections to the tissue around the urethra, according to a study in The Journal of Urology.

The prostate is a gland of the male reproductive system. It produces some of the fluid that transports sperm during ejaculation. After skin cancer, prostate cancer is the most common form of cancer diagnosed in men. Current treatment options include watchful waiting (delay of treatment until signs of cancer progression), surgery, chemotherapy, radiation, and/or hormonal therapy. When surgery is recommended as part of the treatment plan, the surgeon may remove the entire prostate and some of the tissue around it. This procedure is known as a radical prostatectomy.

Many men experience urinary incontinence (leakage of urine) after being treated for prostate cancer or benign prostatic hyperplasia (BPH). Interventions to improve incontinence include surgical placement of an artificial urinary sphincter or a urethral sling or injections to add bulk to the tissue around the urethra (increased bulk around the urethra helps keep the urinary sphincter closed). An advantage of collagen injections is that they can be given under local anesthesia at a doctor’s office. However, the effect of collagen injections is temporary; collagen will eventually break down in the body.

To evaluate both the effectiveness and complications of collagen injections for the short-term treatment of male incontinence, researchers in Texas and Michigan evaluated 322 patients. All patients had received injections of collagen around the urethra to treat incontinence after prostate cancer (307 men) or benign prostatic hyperplasia (15 men). Seventeen percent of men were completely continent (no leakage of urine) after an average of four collagen injections. These men remained continent for an average of 11 months. In the entire group, the average number of pads used per day decreased from five to three, and this improvement lasted an average of six months. The effectiveness of collagen injections appeared to vary by type of prostate treatment; men who had been treated only with a radical prostatectomy were the most likely to benefit from collagen. Complications were rare. Eleven men were temporarily unable to urinate after treatment, and five reported that their incontinence worsened after the collagen injections.

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The researchers conclude that collagen injections are a good option for short-term management of urinary incontinence in men who have had a radical prostatectomy.

Reference: Westney OL, Bevan-Thomas R, Palmer JL et al. Transurethral collagen injections for male intrinsic sphincter deficiency: The University of Texas-Houston experience. *The Journal of Urology.*2005;174:994-997.

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