Periurethral polytetrafluoroethylene injection following urethral reconstruction in female patients with urinary incontinence.

We present our results with periurethral polytetrafluoroethylene (Polytef) injection after urethral reconstruction in 20 female patients with urinary incontinence. These patients have failed previous urethral reconstructive procedures to cure incontinence, including Young-Dees-Leadbetter bladder neck reconstruction, transvaginal urethroplasty, transvaginal urethral plication and vesical flap urethroplasty. Of the patients 4 also underwent a bladder augmentation procedure. After polytetrafluorethylene injection 10 patients (50 per cent) were cured of the incontinence, 2 (10 per cent) had marked improvement from the preoperative condition, 5 (25 per cent) had definite improvement but still wear pads for protection and 3 (15 per cent) had no change from the preoperative condition. Bladder pressure recordings did not demonstrate a difference in results among patients with detrusor stability or instability. Periurethral polytetrafluoroethylene injection remains a valuable procedure in the management of persistent incontinence after bladder neck and urethral reconstruction.