[Intravaginal device for the outpatient treatment of stress urinary incontinence: technique and preliminary results].
OBJECTIVE
To decrease the risks and disadvantages of suburethral prostheses without jeopardising the functional result, thereby allowing an outpatient procedure due to reduction of pain, bleeding and dysuria.


METHODS
In 2005, a prospective study was conducted on 37 patients with simplified suburethral tape. Exclusively intravaginal positioning avoids skin incisions and the sometimes traumatic passage of needles. An umbrella is deployed behind each obturator foramen or behind the perineal membrane in order to maintain a fine tape, the other extremity of which is past through a 2 cm prosthesis, then folded on itself to allow tension-free maintenance of the prosthesis under the urethra. The procedure is rapid and can be performed, if not under local anaesthesia, at least as an outpatient procedure. The procedure lasts less than 10 to 15 minutes and does not require a bladder catheter.


RESULTS
This study was based on a continuous series of 37 patients with pure stress (25), mixed (12), recurrent (8) urinary incontinence, associated with prolapse in 6 cases. No postoperative complications were observed at 1 year. with 1 immediate failure and 36 cured patients; 9 out of 12 patients no longer experience any urgency.


CONCLUSIONS
The low risk of pain, dysuria and bleeding allows an outpatient procedure without any discomfort for the patient. Following the suprapubic and transobturator routes, the intravaginal device may constitute another improvement of the treatment of stress urinary incontinence. Multicentre comparative studies are underway.
Bouffier
Bernard
B
Service Urologie, Clinique Saint- Vincent, Besançon, France. bernard.bouffier@wanadoo.fr
D004867:Equipment Design; D005260:Female; D006801:Humans; D010045:Outpatients; D019919:Prosthesis Implantation; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014621:Vagina