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Treating stress incontinence with the bladder neck support prosthesis
Objective:
To evaluate a vaginal device designed to support the bladder neck in women with urinary stress incontinence.
Study Design:
Thirty physically active women completed the study. All underwent urodynamic evaluation at baseline and with the best fitting Bladder Neck Support Prosthesis (Johnson and Johnson Medical Inc., Arlington, Texas) in place. A bladder diary was maintained before enrollment and during 4 weeks of device use. Outcome measures included changes in the number of reported incontinence episodes, urine loss on stress testing, and changes in urodynamic parameters with the device in place. Patient comfort, convenience, and satisfaction were also evaluated.
Results:
Thirty women completed the study. Twenty-five (84%) were dry with the device in place. Weekly incontinence episodes decreased from ten to three (p < 0.05). Significant changes in functional urethral length, pressure transmission ratio, and Q-tip angle were noted. No evidence of urethral obstruction was noted. The subjects found the device comfortable, easy to use, and convenient.
Conclusions:
The bladder neck support prosthesis reduces stress incontinence symptoms significantly and normalizes urodynamic parameters like a colposuspension.