Minimally invasive surgery for female urinary incontinence: experience with periurethral microballoon implantation.
OBJECTIVE
To assess the effectiveness of periurethral microballoon implantation for management of female urinary incontinence.


METHODS
A total of 45 women with urinary incontinence (age range 47-88 years) were treated between May 2000 and June 2001. Microballoons were placed in the proximal periurethral tissue using endoscopic instrumentation under local anesthesia. Follow-up assessment including urodynamic study and quality- of-life assessment was performed at 1, 3, and 6 months.


RESULTS
Implantation was successful in all cases with no significant adverse effects. Cure was achieved in 60% and improvement in 5%. The failure rate was 35%. Microballoon implantation significantly increased the mean urethral closure pressure, from 35.2 cm H(2)O (SD 14.9; range 15-72 cm H(2)O) to 46.5 cm H(2)O (SD 19.7; range 16-87 cm H(2)O) (P = 0.001). The best predictors of successful outcome in univariate analysis were initial urethral closure pressure (P = 0.047) and degree of incontinence (P < 0.001).


CONCLUSIONS
Periurethral microballoon implantation is a useful technique for the management of female urinary incontinence, especially in elderly and inoperable patients. The microballoons do not present the adverse effects associated with other bulking agents.
Mazouni
Chafika
C
Department of Urology, Salvator Hospital, 249 boulevard Saint Marguerite, 13009 Marseille, France. chafika1@club-internet.fr
Bladou
Frank
F
Karsenty
Gilles
G
Giorgi
Roch
R
Andre
Marc
M
Serment
Gérard
G
D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization; D005260:Female; D006801:Humans; D008875:Middle Aged; D019736:Prostheses and Implants; D014521:Urethra; D014549:Urinary Incontinence / Q000628:therapy*