scholarly journals An Open Multicenter Study of Clinical Efficacy and Safety of Urolastic, an Injectable Implant for the Treatment of Stress Urinary Incontinence: One-Year Observation

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Konrad Futyma ◽  
Paweł Miotła ◽  
Krzysztof Gałczyński ◽  
Włodzimierz Baranowski ◽  
Jacek Doniec ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Clinical Efficacy ◽  
Bulking Agents ◽  
Invasive Treatment ◽  
Cough Test ◽  
Urethral Bulking ◽  
One Year ◽  
Cure Rates ◽  
Patients Experience

The prevalence of stress urinary incontinence rises and affects up to 30% of women after 50 years of age. Midurethral slings are currently the mainstay of surgical anti-incontinence therapy. Some patients experience recurrent SUI (RSUI) which is defined as a failure of anti-incontinence surgery after a period of time or persistence of SUI after the procedure aimed at correcting it. The urethral bulking agent application decreases invasiveness of treatment and meets patients requirements. The objective of this study was to assess the safety and clinical efficacy of Urolastic injection. One hundred and five patients with SUI (including 91 patients with RSUI) were treated with Urolastic in three tertiary gynecological clinics. The efficacy of the procedure was assessed objectively at each follow-up visit by means of cough test and a standard 1-hour pad test. Objective success rate after 12 months after primary procedure in RSUI patients was found in 59.3% of patients. In 14 patients with primary SUI improvement after 1 year was found in 71.4% of patients. Although cure rates after MUS are up to 90% there is still place for less invasive treatment option like periurethral injection of bulking agents, especially in patients with previous SUI surgical management.

scholarly journals Urethral Bulking Agents in the Treatment of Stress Urinary Incontinence

2019 ◽  
Vol 26 (4) ◽  
pp. 84-93
Author(s):  
V. F. Bezhenar ◽  
B. V. Arakelyan ◽  
V. A. Krutova ◽  
O. V. Tarabanova ◽  
A. A. Khachetsukova ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Considerable Effect ◽  
Female Stress Urinary Incontinence ◽  
Bulking Agents ◽  
Invasive Treatment ◽  
Suitable Alternative ◽  
Urethral Bulking Agents ◽  
Urethral Bulking ◽  
High Level

Aim. The article presents information on modern urethral bulking agents used in the treatment of female stress urinary incontinence (SUI).Materials and methods. The authors reviewed the current scientifi c literature on the topic (original articles, monographs, meta-analyses), whose relevance lies in the increasing interest of both clinicians and patients in the minimally invasive treatment of SUI.Results. On the basis of available information on the use of urethral bulking agents, regulatory bodies prohibited the use of substances that did not meet the requirements of safety and effi cacy. Substances approved for clinical use are safe and show considerable effect, which makes them a suitable alternative to the surgical treatment of SUI.Conclusions. This kind of treatment is characterised by a low rate of serious complications and a suffi ciently high level of patients’ satisfaction with the results, despite its lower objective cure rate. Further research in this area involves a search for the “ideal” urethral bulking agent, as well as the use of cell technologies.

scholarly journals Can reducing the number of stitches compromise the outcome of laparoscopic Burch surgery in the treatment of stress urinary incontinence? Systematic review and meta-analysis

2017 ◽  
Vol 44 (6) ◽  
pp. 649-654 ◽  
Author(s):  
RICARDO JOSÉ SOUZA ◽  
JOSÉ ANACLETO DUTRA RESENDE JÚNIOR ◽  
CLARICE GUIMARÃES MIGLIO ◽  
LEILA CRISTINA SOARES BROLLO ◽  
MARCO AURÉLIO PINHO OLIVEIRA ◽  
...  
Keyword(s):  
Systematic Review ◽  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
P Value ◽  
Open Technique ◽  
Control Series ◽  
One Year ◽  
Cure Rates

ABSTRACT The retropubic colposuspension in the treatment of stress urinary incontinence has been rescued with the laparoscopic route. Some authors have reduced the number of stitches, from two to one, due to the difficulty of suturing by this route. To what extent can this modification compromise outcome? To answer this question, we performed a systematic review and meta-analysis on the MEDLINE/PubMed and LILACS/SciELO databases between 1990 and 2015. We included randomized clinical trials, cohort studies and case-control series comparing laparoscopic versus open Burch, and two versus one stitch in laparoscopic Burch, with a minimum follow-up of one year. Fourteen studies compared laparoscopic versus open Burch, in which we found no differences between the two techniques using one stitch (Relative Risk - RR - of 0.94, 95% CI 0.79-1.11) and two stitches (RR of 1.03, 95% CI 0.97-1.10). Only one study compared one stitch versus two stitches in laparoscopic Burch, with cure rates of 68% versus 87%, respectively (p-value= 0.02). We did not identify differences when compared open technique with two stitches versus laparoscopic with one stitch and open technique with two stitches versus laparoscopic with two. The study comparing one versus two laparoscopic stitches demonstrated superior results with the latter. Although there is no robust evidence, when Burch surgery is performed laparoscopically, the use of two stitches seems to be the best option.

Stress Urinary Incontinence I: Nonsurgical Management

2020 ◽  
Author(s):  
Svjetlana Lozo ◽  
Sylvia M Botros
Keyword(s):  
United States ◽  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Pelvic Floor ◽  
The United States ◽  
Pharmacologic Therapy ◽  
Bulking Agents ◽  
Urethral Bulking Agents ◽  
Nonsurgical Management ◽  
Urethral Bulking

Conservative management of stress urinary incontinence (SUI) is generally offered as first-line treatment. Such treatment options include behavioral therapy, pelvic floor muscle therapy, vaginal devices, pharmacologic therapy, and urethral bulking agents. Weight loss management is an example of an effective behavioral strategy in obese patients. Pelvic floor physical therapy alone or under the supervision of skilled providers can significantly improve SUI; however, long-term effects are harder to maintain. Pessaries, vaginal cones, and vaginal inserts have been widely used for treatment of SUI and are beneficial in patients who are motivated to use them. Currently in the United States, there is no FDA-approved medication for the treatment of SUI. Conversely, the European Union has approved and used duloxetine. Urethral bulking agents are indicated for patients with intrinsic sphincter deficiency and sometimes used in patients who are not able to undergo surgical procedures for SUI or who have failed said procedures. Three materials are currently FDA approved for urethral bulking in the United States. Many options exist for the nonsurgical management of SUI. This review contains 5 tables and 47 references  Key words:  Stress Urinary Incontinence, conservative treatment, urethral bulking, pelvic floor exercises, incontinence pessaries.  

scholarly journals Urolastic—A New Bulking Agent for the Treatment of Women with Stress Urinary Incontinence: Outcome of 12 Months Follow Up

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Janusz Zajda ◽  
Fawzy Farag
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Bulking Agent ◽  
Adult Women ◽  
Efficacy And Safety ◽  
Urethral Bulking ◽  
Safety Parameters ◽  
The Mean ◽  
One Year ◽  
Injection Procedure

Objective. To evaluate the efficacy and safety of the new injectable implant, Urolastic, in women with stress urinary incontinence (SUI) after 12-month followup.Materials and Methods. A prospective, cohort study included adult women with SUI. Patients were treated with Urolastic periurethral injections under local anaesthesia. The injection procedure was repeated after 6 weeks when indicated. Patients were evaluated for efficacy and safety parameters 6 weeks, 3 months, and 12 months after therapy.Results. Twenty women 56 (33–71) years old were included. Thirteen patients (65%) received one injection each (overall average of 2,1 mL); 7 patients (35%) received a second injection. Nineteen patients complete the 12-month followup. The mean Stamey incontinence grade significantly decreased from 1.9 at baseline to 0.4 at 12 months (visit IV) (P<0.001). None of the patients were dry at baseline; 68% of them were dry at 12 months. The mean number of incontinence episodes significantly decreased from 6/day at baseline to 1.6/day at visit IV (P<0.001). Reduction in pad weight went from 20.2 to 7.8 g at one year. The mean I-QoL score significantly increased from 51 at baseline to 76 at visit IV (P<0.001). Six patients (30%) developed minor complications related to the injection procedure.Conclusions.Urolastic is effective and long-standing urethral bulking agent with moderate adverse events.

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