title: The bacteriological changes after re-using a vaginal continence guard.
abstract: BACKGROUND
  Involuntary loss of urine is a major health care problem, especially in women. The Conveen Continence Guard is a non-surgical treatment of stress incontinence. A possible risk of vaginal devices is introduction of changes in bacteriological flora of the vagina, especially after re-use of the guard. Moreover, vaginal devices can induce magnesium ion deficiency and thereby facilitate growth of Staphylococcus Aureus. This can lead to the production of toxin-1, eventually resulting in toxic shock syndrome.
  
  
  METHODS
  The first aim of this study was to investigate the capacity to absorp magnesium ions in an in-vitro study. Secondly, 14 patients with stress incontinence were examined for bacteriological changes in the vagina after re-using the continence guard for four days. After completing this study the patients were asked whether re-using the continence guard was as convenient as single use.
  
  
  RESULTS
  The continence guard had no absorption capacity for magnesium ions. The vaginal bacteriological changes after re-use showed in 11% changes in bacterial growth and in 20% increased bacterial growth. Only one patient developed a vaginal colonization with Staphylococcus Aureus but had no symptoms of disease. The continence guard showed itself to be less effective in preventing stress incontinence after re-use.
  
  
  CONCLUSIONS
  Although re-use of the continence guard is feasable from a bacteriological point of view, re-use renders the device less effective.
authors.affiliation: Department of Obstetrics and Gynecology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.
authors.forename: I
authors.initials: I
authors.lastname: van Zon-Rabelink
authors.forename: J
authors.initials: J
authors.lastname: Laven
authors.forename: M
authors.initials: M
authors.lastname: Vleugels
mesh_terms: D000042:Absorption; D000328:Adult; D000368:Aged; D001419:Bacteria / Q000254:growth & development*; D015169:Colony Count, Microbial; D003362:Cost-Benefit Analysis; D004866:Equipment Contamination; D017743:Equipment Reuse; D005260:Female; D006801:Humans; D007477:Ions; D008274:Magnesium / Q000032:analysis*; D008422:Materials Testing; D008875:Middle Aged; D010570:Pessaries / Q000009:adverse effects* / Q000191:economics / Q000382:microbiology*; D013997:Time Factors; D014550:Urinary Incontinence, Stress / Q000628:therapy*; D014621:Vagina / Q000737:chemistry* / Q000382:microbiology*; D014626:Vaginal Smears
chemical_list: D007477:Ions; D008274:Magnesium