Stress Urinary incontinence Male and Female Inject Control - - PowerPoint PPT Presentation

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Aug 15, 2023 162 likes •458 views

Stress Urinary incontinence Male and Female Inject Control Stress urinary incontinence (SUI) is characterised by the involuntary leakage of urine, typically upon exercise, coughing or sneezing. It is a common condition that may affect 10-

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Stress Urinary incontinence

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Male and Female

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Inject Control

Stress urinary incontinence (SUI) is characterised by the involuntary

leakage of urine, typically upon exercise, coughing or sneezing. It is a common condition that may affect 10- 40% of women across all age groups.

SUI can have a significant impact on the quality of life for people

with the condition which can include social isolation and poor self-

esteem. Many women just accept the condition as part of the ageing

process and rely on pads and changes to their lifestyle to manage the condition.

There are a number of treatment options for SUI. Urethral bulking is

a minimally invasive option and offers an effective and safe alternative to open surgery. It is an ideal first line treatment option for mild to moderate SUI.

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TVT

Cure Rates 85% Complication Bladder Perforation

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TOT

Cure Rates 85% Complication Erosion

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Birch Colposuspension

Cure Rates 80% Complication Haematoma

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SUI

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Suitability

Women who prefer a minimally invasive option
Women not suitable for a general anesthetic
Women with residual incontinence post a surgical procedure

such as sling insertion

Women of childbearing age

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Stenberg etal. Urethral Injection for SUI: Long term results with dextranomer/HA

Int. Urogyn Journal. 2003

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Materials and Methods

Direct cystoscopic placement
4, 8 and 6 o’clock
Mean volume was 6.4mL
Age average: 67 years
Duration: 9 years

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Long Term Results

20 SUI pts. 9 cured 3 no Δ 7 improved 5 dry 3 worse 4 stable 3 remain incontinent 1 worse 6 months Long term (78mos)

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Safety

No evidence of any unexpected deterioration in health
No emergence of any long term safety concerns
NO pseudocysts

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Chapple etal. An Open, Multicentre Study of NASHA/Dx Gel for the Treatment of Stress Urinary Incontinence

European Urology 48 (2005) 488–494

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Materials and Methods

142 women aged 18 years +
History of SUI for 12 months
Avg age, 56 years
Mean number of deliveries: 2
Menopausal 62%

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Results: % Responders

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Results

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Male Incontinence

Stress urinary incontinence (SUI) is an increasing problem among men, creating a huge negative impact on their quality

f life. There are many risk factors, but the primary cause
f male SUI is prostate surgery - in particular, radical

prostatectomy for the removal of localized prostate

cancer. The occurrence of urinary incontinence following

radical prostatectomy ranges between 5% - 45%.

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The number of men who undergo prostate surgery is constantly increasing. Over 500,000 new prostate cancer cases are diagnosed each year worldwide. Thus, the social and hygienic inconvenience that comes with SUI is also rising.

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Radical Retropubic Prostetectomy

Lepor et al J Urol: 2004

500 consecutive men
HRQOL outcomes at 3,6,12 and 24 months
All had localized disease

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Post prostatectomy incontinence is often

underestimated. In fact, the occurrence of

incontinence experienced by patients is 2-3 times higher than that officially reported. It is important to remember that losing the ability to control urination or having to wear pads is distressing. Sometimes the fear is so intense that men refuse to undergo radical prostatectomy

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Several studies demonstrate that DEFLUX is a suitable and efficient treatment for post-prostatectomy

incontinence. According to one study

(Alloussi ), 58% of Grade 2 patients were dry 4-8 weeks after injection, and 39% experienced a reduction in incontinence by at least one degree

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Summary

Deflux can be administered under general anesthetic or local

sedation

It is a minimally invasive procedure
Deflux is proven to have minimal side effects
There is a return to normal activity within 24 – 48 hours
Studies demonstrate a success rate of 74%
It does not affect more major surgery at a later stage, if required.
Requires short-acting general anesthesia
Made from materials that have been in medical use for over a

decade

Deflux has been shown to remain in place for over 4 years
On average if patients require a repeat injection it is administered at

5 years

1 Cerwinka 2008; 2DEFLUX Package Insert 2009; 3Data on file; 4Stenberg 1997; 5Stenberg 2003