Urethral Devices for Managing Stress Urinary Incontinence

Abstract

Although surgery remains the gold standard for managing the majority of patients with stress urinary incontinence or retention, not all patients are suitable candidates or desire surgery. For these patients, several urethral caps and inserts are available, which are described. In approximately 50% of patients, satisfactory control is achieved. Further investigation undoubtedly will yield better devices to serve the large number of patients with urinary control problems.

European and Asian guidelines on management and prevention of catheter-associated urinary tract infections

“…In stress incontinence approximately 50% achieved satisfactory control [68] (III). Bacteriuria, which is usually asymptomatic, occurs in 10-35% of patients [68][69][70][71][72][73][74][75] (III). There are no well-designed studies investigating the significance of bacteriuria or symptomatic UTI in correlation with various urethral inserts and stents in comparison with other drainage methods.…”

The management of female urinary stress incontinence: II. The use of devices

“…The only information on the Femsoft ® insert (Fig. 7) was recently published by Elliott and Boone [25], who reported values given by the manufacturer. The continence rates were good, with a high satisfaction rate of 85% in patients using the device.…”

PDMS and DLC‐coated unidirectional valves for artificial urinary sphincters: Opening performance after 126 days of immersion in urine

“…On the other hand, endo‐urethral AUS consist of miniaturized devices, featured by significantly smaller invasiveness, placed inside the urethral canal by an endo‐luminal procedure with standard urinary tools under local or total anesthesia or by self‐insertion by the patient. Only a few endo‐urethral solutions are currently on the market, such as the Reliance System (UroMed Inc.) 8 and the FemSoft Insert (Rochester Medical Corp.) 9 …”

“…Regarding the AUS reported in Reference 10, the main component subjected to a risk of functional failure due to encrustations is the polymeric valve, made of polydimethylsiloxane (PDMS) 12 . Anyhow, there are many other endo‐urethral devices based on silicone 9 . Thus, assessing the functionality over time of silicone components (the PDMS valve in this case) would provide important hints on the possible long‐term stability of these devices in the urinary system.…”