Suburethral abscess: a complication of periurethral collagen injection therapy

BACKGROUND: Urinary tract infection after collagen injection is well documented. Other adverse reactions are rare. CASES: Three women experienced suburethral abscess after repeat periurethral injections. All patients received local skin preparation and postprocedural antibiotics. Symptoms failed to resolve with antibiotics. The first two patients presented after 5 weeks and 10 days with irritative voiding symptoms and a tender suburethral swelling. The first patient was treated with excision. Spontaneous rupture into the urethra occurred with the second. The third woman presented with acute urinary retention at 102 days. A large suburethral mass was drained successfully in the office. CONCLUSION: Suburethral abscess may be a delayed complication of periurethral collagen injections, not preventable by postprocedural antibiotics. Drainage is required.