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Proper patient selection for Contigen Bard Collagen implant
1St. Vincent's Private Medical Centre, Sydney, NSW, Australia.
Summary
Contigen Bard Collagen Implant offers a nonsurgical option for stress urinary incontinence caused by intrinsic sphincter deficiency (ISD). Proper patient selection through thorough diagnostic evaluation is crucial for optimal outcomes.
Area of Science:
- Urology
- Gynecology
- Medical Devices
Background:
- Stress incontinence, often due to intrinsic sphincter deficiency (ISD), primarily affects women.
- Surgical treatments like artificial sphincters or pubovaginal slings are traditional options for ISD.
- Contigen Bard Collagen Implant presents a nonsurgical alternative for urinary incontinence management.
Purpose of the Study:
- To outline the indications and contraindications for Contigen Implant in treating ISD.
- To emphasize the importance of proper patient selection for optimal treatment outcomes.
- To detail the diagnostic evaluation process required before considering Contigen Implant.
Main Methods:
- Basic evaluation includes history, physical examination, urinalysis, voiding diary, and pad test.
- Urodynamic evaluation by a urologist is recommended for confirmed incontinence cases.
- Urodynamic studies may include cystometry, uroflowmetry, cystogram, leak point pressure, and post-void residual measurement.
Main Results:
- Contigen Implant is indicated for urinary incontinence resulting from ISD.
- Ideal candidates typically have failed previous suspensions and an open bladder neck at rest.
- Poor candidates include those with hypermobile urethra, high leak point pressures, or significant detrusor issues.
Conclusions:
- Optimal outcomes with Contigen Implant depend on meticulous patient selection.
- A comprehensive diagnostic and urodynamic evaluation is essential for identifying suitable candidates.
- Contigen Implant provides a viable nonsurgical treatment option for carefully selected patients with ISD.