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Bladder Neck Support Prosthesis: A Nonoperative Treatment for Stress or Mixed Urinary Incontinence

1997; Lippincott Williams & Wilkins; Volume: 157; Issue: 3 Linguagem: Inglês

10.1016/s0022-5347(01)65055-9

1527-3792

Atsuo Kondo, Eiji Yokoyama, Ken Koshiba, Junnosuke Fukui, Momokazu Gotoh, Yoko Yoshikawa, Takumi Yamada, Mineo Takei,

Urinary Tract Infections Management

No AccessJournal of UrologyClinical Urology: Original Article1 Mar 1997Bladder Neck Support Prosthesis: A Nonoperative Treatment for Stress or Mixed Urinary Incontinence Atsuo Kondo, Eiji Yokoyama, Ken Koshiba, Junnosuke Fukui, Momokazu Gotoh, Yoko Yoshikawa, Takumi Yamada, and Mineo Takei Atsuo KondoAtsuo Kondo , Eiji YokoyamaEiji Yokoyama , Ken KoshibaKen Koshiba , Junnosuke FukuiJunnosuke Fukui , Momokazu GotohMomokazu Gotoh , Yoko YoshikawaYoko Yoshikawa , Takumi YamadaTakumi Yamada , and Mineo TakeiMineo Takei View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)65055-9AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated the usefulness and safety of a bladder neck support prosthesis in patients with stress or mixed incontinence. Materials and Methods: A total of 57 women with stress and 20 with mixed incontinence completed a 12-week prospective clinical trial of a bladder neck support prosthesis. While indexes of incontinence episodes, leakage amounts and urgency along with a bothersome index were subjectively evaluated, a 60-minute pad test and urinary flow parameters were objectively evaluated. Three patients scheduled to undergo surgery for stress incontinence voluntarily used the device, and provided urodynamic data and cystourethrograms. Two prongs at 1 end of the ring, a type of elastic vaginal pessary, elevate the bladder neck against the pubic bone and facilitate pressure transmission around the bladder neck, resulting in urinary continence. Results: Four subjective indexes significantly improved. There was no urinary flow obstruction. Urine loss decreased from 20.6 to 4.8 gm. per hour (p <0.001) on the 60-minute pad test. Of the patients 22 (29%) reported complete continence and 39 (51%) had decreased severity of incontinence by more than 50%. Minor adverse effects occurred in 26% of the patients. Taking subjective evaluation, changes in objective parameters and adverse effects into consideration, 62 patients (81%) had some or maximum benefit according to the global usefulness rating. Conclusions: The bladder neck support prosthesis is safe, well tolerated and clinically effective for the treatment of stress or mixed incontinence. References 1 : Urodynamic findings in patients after failure of stress incontinence operations. Prog. Clin. Biol. Res.1981; 78: 351. Google Scholar 2 : Stress incontinence: classification and surgical approach. J. Urol.1988; 139: 727. Link, Google Scholar 3 : A comparison of endoscopic suspension of the vesical neck with suprapubic vesicourethropexy for treatment of stress urinary incontinence. J. Urol.1987; 137: 411. Link, Google Scholar 4 : Pelvic floor muscle exercise for the treatment of female stress urinary incontinence: III. Effects of two different degrees of pelvic floor muscle exercises. Neurourol. Urodynam.1990; 9: 489. Google Scholar 5 : A silastic vaginal device for the treatment of stress urinary incontinence. Neurourol. Urodynam.1988; 7: 271. Google Scholar 6 : The standardisation of terminology of lower urinary tract function. The International Continence Society committee on standardisation of terminology. Scand. J. Urol. Nephrol.1988; 114: 5. Google Scholar 7 : The bladder neck support prosthesis: A nonsurgical approach to stress incontinence in adult women. Amer. J. Obst. Gynec.1994; 171: 206. Google Scholar 8 : Treatment of stress incontinence by vaginal cones: short- and long-term results and predictive parameters. Brit. J. Urol.1995; 76: 464. Google Scholar 9 : The urethral plug II: an alternative treatment in women with genuine urinary stress incontinence. Brit. J. Urol.1993; 72: 428. Google Scholar 10 : A multicenter experience using an expandable urethral occlusion device for management of urinary stress incontinence. Neurourol. Urodynam.1994; 13: 380. Google Scholar Departments of Urology, Nagoya University Hospital, Nagoya, Kitasato University Hospital, Sagamihara, St. Luke's International Hospital, Tokyo, Hekinan Municipal Hospital, Hekinan, Kasukabe Municipal Hospital, Kasukabe and Hara-Sansin General Hospital, Fukuoka, Japan© 1997 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byMOORE K, SIMONS A, DOWELL C, BRYANT C and PRASHAR S (2018) EFFICACY AND USER ACCEPTABILITY OF THE URETHRAL OCCLUSIVE DEVICE IN WOMEN WITH URINARY INCONTINENCEJournal of Urology, VOL. 162, NO. 2, (464-468), Online publication date: 1-Aug-1999. Volume 157Issue 3March 1997Page: 824-827 Advertisement Copyright & Permissions© 1997 by American Urological Association, Inc.MetricsAuthor Information Atsuo Kondo More articles by this author Eiji Yokoyama More articles by this author Ken Koshiba More articles by this author Junnosuke Fukui More articles by this author Momokazu Gotoh More articles by this author Yoko Yoshikawa More articles by this author Takumi Yamada More articles by this author Mineo Takei More articles by this author Expand All Advertisement PDF downloadLoading ...