Endoscopic macroplastiqueTM injection for the treatment of female stress incontinence. Role and efficacy

ABSTRACT

Objectives To evaluate the role; safety and efficacy of endoscopic MacroplastiqueTM implants in the management of female stress incontinence. Material and Methods Between 1995 and 1999; transurethral submucosal injection of MacroplastiqueTM was performed in 68 women (mean age 58 years; range 32 - 85 years) for the treatment of genuine stress incontinence. Fourteen patients had undergone previous surgery for incontinence that had failed to correct the problem. Under general or regional anaesthesia; the Macroplastique was injected sub-mucosally 1 cm distal to the bladder neck at 3; 6 and 9 o' clock positions. In 26 cases the 12 o' clock position was chosen to ensure a good occlusion of the bladder neck. The mean volume of Macroplastique injected was 3 ml. Results At a mean follow-up of 19 months; 24 patients (35.3) were dry; 18 patients (26.5) were improved and 26 patients (38.2) were still wet. Complications were all minor. Conclusion Transurethral submucosal injection of MacroplastiqueTM should be used in women with mild to moderate stress incontinence who have failed to respond to physiotherapy. Being a minimally invasive day case procedure with low morbidity which can be repeated if necessary and has a satisfactory success rate; we believe Macroplastique implantation could be a good alternative line of treatment for stress incontinence