Magnetic resonance imaging to evaluate NASHA/Dx gel (Zuidex) for stress urinary incontinence

The Zuidex system for the treatment of stress urinary incontinence consists of non-animal stabilised hyaluronic acid/dextranomer (NASHA/Dx) gel and a precision guide, the Implacer. Whether the Implacer accurately deposits NASHA/Dx gel in the desired location within the urethral wall was investigated by magnetic resonance imaging (MRI), performed at a mean of 35 days post-treatment. Three or more deposits were observed in 11 of 16 patients (68.8%), with 39 of the 50 deposits clearly located within the urethral wall, as intended. Fourteen of 16 patients (87.5%) demonstrated improvement in their incontinence at 3 months, sustained at 12 months in 13 patients. No significant correlations between total implant volume and improvements in incontinence were observed at 3 months (p > or = 0.16) and 12 months (p > or = 0.30). In conclusion, accurate placement of NASHA/Dx gel into the desired location within the urethral wall was achieved in the majority of cases using the Implacer device, without endoscopic guidance.