Endoscopic correction of intractable stress incontinence with silicone micro-implants

Abstract

Objective: To assess the clinical value of silicone micro-implants (Macroplastique, Uroplastique, Bioplastique) in the treatment of intractable genuine stress incontinence.

Materials and methods: Between January 1992 and March 1995, 34 patients with failed previous surgery for genuine stress incontinence were treated with transurethral submucosal injection of Macroplastique.

Results: The initial success rate was high, 90% at 1 month and 75% at 3 months postoperatively. However, at 2 years of follow-up the success rate fell to 48%. Patient satisfaction was high.

Conclusion: Macroplastique is a relatively simple and effective day-case procedure for intractable genuine stress incontinence. It may have a place as a last-resort surgery for genuine stress incontinence predominantly due to sphincter incompetence in an unfit patient with failed previous anti-incontinence procedures despite good repositioning of the bladder neck. However, many more patients and a much longer follow-up are needed before any further meaningful statements can be made about the success or failure of this material.