Macroplastique implantation system for the treatment of female stress urinary incontinence.
OBJECTIVE
We evaluated the 12-month followup outcome of the Macroplastique (Uroplasty, Minneapolis, Minnesota) implantation system for the treatment of stress urinary incontinence caused by intrinsic sphincter deficiency using objective and subjective measures, including quality of life impact.


METHODS
A total of 21 consecutive women with a mean age of 47.4 years and a mean body mass index of 25.65 kg./m.2 in whom intrinsic sphincter deficiency was urodynamically diagnosed were enrolled in the study. Patients were preoperatively assessed by physical examination, quality of life questionnaire, Stamey grading of incontinence, pad use, pad weight test and urodynamic testing. Patients underwent periurethral injection under local anesthesia with the Macroplastique implantation system. The mean volume of silicone elastomers injected was 6.3 ml.


RESULTS
As assessed by the King health questionnaire, patient quality of life improved in all domains and in most lower urinary tract symptoms. Patient satisfaction and subjective surgeon evaluation were assessed by Stamey incontinence grading. From patient point of view 12 (57.1%) considered themselves cured, 4 (19%) were improved and 5 (23.8%) had failure. According to subjective surgeon grading 8 patients (38.1%) were considered cured 6 (28.6%) were improved and 7 (33.3%) had failure. Pad use decreased from a mean of 4.38 to 1.29 units daily. According to the pad weight test 13 patients (62%) were dry, 4 (19%) were improved and 4 (19%) had failure. Urodynamic testing demonstrated that 8 patients (40%) were dry and 1 (5%) was improved.


CONCLUSIONS
The Macroplastique implantation system proved to have an acceptable outcome for patient and surgeon. The procedure can be done with local anesthesia and without cystoscopic guidance.
Tamanini
José Tadeu Nunes
JT
Division of Urology, Faculdade de Ciências Médicas da Universidade Estadual de Campinas-Unicamp and Hospital Maternidade Leonor Mendes de Barros, São Paulo, Brazil.
D'Ancona
Carlos Arturo Levi
CA
Tadini
Valdir
V
Netto
Nelson Rodrigues
NR
D000328:Adult; D004129:Dimethylpolysiloxanes; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D008875:Middle Aged; D017060:Patient Satisfaction; D019736:Prostheses and Implants / Q000009:adverse effects; D011788:Quality of Life; D014550:Urinary Incontinence, Stress / Q000628:therapy*
D004129:Dimethylpolysiloxanes