A bladder-neck support prosthesis for women with stress and mixed incontinence

G. Willy Davila, Durwood Earnest Neal, Nicolette Horbach, Jörge Peacher, J. Darryl Doughtie, Mickey Karram

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objective: To evaluate the safety and efficacy of a bladder-neck support prosthesis, a vaginal device designed to support the bladder neck, in women with genuine stress and mixed incontinence. Methods: For enrollment, incontinent women underwent a history, physical examination including cotton- swab test, urinalysis, postvoid residual urine, and multichannel urodynamic testing. Those with genuine stress incontinence or mixed incontinence and urethral hypermobility completed 7-day bladder diaries, the Incontinence Impact Questionnaire, and underwent standardized pad tests. They were fitted with a prosthesis and seen weekly to optimize fit and efficacy. At week 5, they underwent repeat evaluations with the best-fitting prosthesis in place. Results: Seventy women were enrolled and 53 completed the 1-month study (29 genuine stress incontinence, 24 mixed incontinence). The mean ages were 50.4 years for genuine stress incontinence (range 24-76) and 55.7 years for mixed incontinence (range 30-88). A statistically significant reduction in incontinence was noted on pad testing (genuine stress incontinence, mean 46.6-16.6 g; mixed incontinence, mean 31.9-6.8 g) and in the bladder diary (genuine stress incontinence, mean 28.6-7.8 losses per week; mixed incontinence, mean 30.2-15 losses per week). Quality-of-life scores improved in both groups. With the device in place, urodynamic testing indicated normalization of urethral function without evidence of outflow obstruction. Subjects found the device comfortable, easy to use, and convenient. Side effects included five urinary tract infections and 23 cases of vaginal mucosal soreness or mild irritation. Conclusion: The bladder-neck support prosthesis significantly reduced involuntary urine loss in women with stress and mixed incontinence.

Original languageEnglish (US)
Pages (from-to)938-942
Number of pages5
JournalObstetrics and Gynecology
Volume93
Issue number6
DOIs
StatePublished - Jun 7 1999
Externally publishedYes

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Prostheses and Implants
Urinary Bladder
Neck
Urodynamics
Equipment and Supplies
Prosthesis Fitting
Urine
Urinalysis
Urinary Tract Infections
Physical Examination
History
Quality of Life
Safety

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

A bladder-neck support prosthesis for women with stress and mixed incontinence. / Willy Davila, G.; Neal, Durwood Earnest; Horbach, Nicolette; Peacher, Jörge; Darryl Doughtie, J.; Karram, Mickey.

In: Obstetrics and Gynecology, Vol. 93, No. 6, 07.06.1999, p. 938-942.

Research output: Contribution to journalArticle

Willy Davila, G, Neal, DE, Horbach, N, Peacher, J, Darryl Doughtie, J & Karram, M 1999, 'A bladder-neck support prosthesis for women with stress and mixed incontinence', Obstetrics and Gynecology, vol. 93, no. 6, pp. 938-942. https://doi.org/10.1016/S0029-7844(99)00240-9
Willy Davila, G. ; Neal, Durwood Earnest ; Horbach, Nicolette ; Peacher, Jörge ; Darryl Doughtie, J. ; Karram, Mickey. / A bladder-neck support prosthesis for women with stress and mixed incontinence. In: Obstetrics and Gynecology. 1999 ; Vol. 93, No. 6. pp. 938-942.
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AB - Objective: To evaluate the safety and efficacy of a bladder-neck support prosthesis, a vaginal device designed to support the bladder neck, in women with genuine stress and mixed incontinence. Methods: For enrollment, incontinent women underwent a history, physical examination including cotton- swab test, urinalysis, postvoid residual urine, and multichannel urodynamic testing. Those with genuine stress incontinence or mixed incontinence and urethral hypermobility completed 7-day bladder diaries, the Incontinence Impact Questionnaire, and underwent standardized pad tests. They were fitted with a prosthesis and seen weekly to optimize fit and efficacy. At week 5, they underwent repeat evaluations with the best-fitting prosthesis in place. Results: Seventy women were enrolled and 53 completed the 1-month study (29 genuine stress incontinence, 24 mixed incontinence). The mean ages were 50.4 years for genuine stress incontinence (range 24-76) and 55.7 years for mixed incontinence (range 30-88). A statistically significant reduction in incontinence was noted on pad testing (genuine stress incontinence, mean 46.6-16.6 g; mixed incontinence, mean 31.9-6.8 g) and in the bladder diary (genuine stress incontinence, mean 28.6-7.8 losses per week; mixed incontinence, mean 30.2-15 losses per week). Quality-of-life scores improved in both groups. With the device in place, urodynamic testing indicated normalization of urethral function without evidence of outflow obstruction. Subjects found the device comfortable, easy to use, and convenient. Side effects included five urinary tract infections and 23 cases of vaginal mucosal soreness or mild irritation. Conclusion: The bladder-neck support prosthesis significantly reduced involuntary urine loss in women with stress and mixed incontinence.

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