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The Toronto Hospital Study Compares
the Benefits of Collagen Injection
and Surgery for Common Bladder Condition Affecting Many Women
(March 19, 1997, Toronto) Simply laughing or sneezing could prove to be embarrassing for some people. Especially women who suffer from a debilitating condition known as stress urinary incontinence. This condition causes its sufferers to leak urine when they laugh, sneeze, or undergo any activity such as playing tennis or doing housework. It's a common condition, affecting approximately 10 to 40 per cent of women over 40.
Currently, there are two treatments for moderate to severe stress incontinence: collagen injections and surgery. But no studies have been conducted comparing the two. The Toronto Hospital is enrolling 28 women to participate in a trial comparing the benefits of surgery versus collagen injections. The three-year study involving five centres in Canada is sponsored by a Medical Research Council grant and Bard Canada, a collagen manufacturer. "We offer both treatments for women suffering from incontinence, and yet there's never been a study comparing the two," says Dr. Sidney Radomski, a urologist at The Toronto Hospital and Director of the TTH Urodynamics Laboratory. "Both treatments have their advantages and disadvantages. We want to determine which would be best for our patients."
Surgery, which prevents the bladder from falling or compressing the urethra, is invasive and usually requires a hospital stay of five days. It has a cure rate of 85 per cent. Meanwhile, collagen injection is minimally invasive and can be done under local anesthetic on an outpatient basis. During the procedure, collagen is inserted into the urethra to build it up to prevent leakage. Its cure rate is 35 per cent, but its cured or improved rate is 80 per cent. A major drawback of collagen is its cost. It is expensive and not covered by OHIP.
"Surgery may have a higher cure rate," Dr. Radomski says. "However, there are some risks associated with surgery. Furthermore, not all elderly people may qualify for surgery because of their health or age." The patients in the trial will be randomized meaning they'll be randomly selected into the two treatment methods. They'll be followed up by questionnaire at one, three, six, and 12 months following treatment.
The Toronto Hospital is a leader in the area of incontinence treatment, research and teaching and provides one-stop service for patients in need of help. Available treatments at the hospital include laporoscopic surgery; collagen injections; biofeedback, a method of retraining the pelvic floor muscles to improve bladder control; and an electrical nerve stimulator implant which sends continuous electrical signals to the sacral nerves. The sacral nerves, located near the tailbone, control voiding function.
Urinary Incontinence Fact Sheet
2 million Canadians suffer from incontinence
30 per cent of people over 60 have incontinence
10-20 per cent of those between the ages of 20 and 40 have some degree of
incontinence
75 to 85 per cent of people with incontinence could have their condition
improved or cured, but only 20 to 30 per cent seek treatment
50 per cent of patients in chronic care or nursing homes have incontinence
incontinence products such as pads represent an $8 billion industry in North
America
incontinence affects both men and women
For information about the trial, call Dr. Sidney Radomski, (416) 603-5713.
For more information, contact Josey Panetta, Senior Media Relations Officer, The Toronto Hospital, (416) 340-3303.