The investigators aimed to evaluate the effectiveness and safety of intraurethral cross-linked hyaluronic acid/dextranomer (CLHA/Dx) injection for the treatment of stress urinary incontinence (SUI) in women.
Diagnosis of Stress Urinary Incontinence.
Presence of incontinence during the Valsalva maneuver.
Positive Marshall-Marchetti test result.
Post-void residual urine volume of ≤100 mL.
Temporary urinary incontinence.
Delirium.
Urinary tract infection.
Urethritis.
Parallel
Intraurethral injection
Procedure/SurgeryProcedure: Intraurethral injection Patients are positioned in the lithotomy position during the procedure. General and/or local anesthesia is administered depending on the investigator\'s preference. An applicator developed for intraurethral injection will be used. This device comprises a holder that is placed into and fixates the urethra (i.e., it distends the urethral circumference, thus smoothing out the longitudinal folds), allowing the use of four syringes to inject cross-linked hyaluronic acid/dextranomer at approximately the 2, 4, 8, and 10 o'clock positions. Drug: Cross-linked hyaluronic acid/dextranomer
Mid-urethral sling
Procedure/SurgeryProcedure: Starting with the dorsal lithotomy position, a foley catheter is inserted to the urethra. Starting with 1-1.5 cm below the urethral meatus, a 1.5-2 cm vertical incision is made. Following the dissection of anterior vaginal mucosa, pubocervical fascia should be dissected sharply . Dissection is continued laterally to the ischiopubic ramus. Starting downwards from the tendinous insertion of the adductor longus muscle at the level of clitoris, a 1cm incision is made close to the bone. The needle is placed in to the incision and passed medially through the obturator membrane. It has to be considered that the needle is passed very close to the bone in order not to damage the obturator vessel-nerve bundle. With the guidance of the opposite hand's index finger in the vaginal incision the tip of the needle has to be palpated afterwards passing with a 45-degree angle rotation. The next manoeuvre is passing the tip of the needle beside the urethra through the vaginal incision .
Need for addtional treatment within the 3st month
Patients who are needed to treat with re-injection or other surgical approaches.
Need for addtional treatment within the 1st month
Patients who are needed to treat with re-injection or other surgical approaches
Need for addtional treatment within the 6 st month
Patients who are needed to treat with re-injection or other surgical approaches
Presence of complication within 6 months after intervention
Presence of complication such as infection at injection site, urinary tract infection, hematuria, persistent pain, de novo urge incontinence) in all patients.
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