New approach to the management of stress urinary incontinence in patients with treatment failure.

Urinary incontinence affects about 40 million adults in the Western world. Many mechanical, behavioral, and surgical approaches have been used for its treatment. Many of the surgical techniques are successful, but about 50% of patients need re-treatment after 5 to 7 years. Although intraurethral plug-like devices could block the leak, they create a communication between the bladder and vulva, resulting in high rates of ascending urinary infections. To prevent this communication but block the bladder outlet while allowing it to open voluntarily, a new intravesical device was designed. The device could be inserted easily into the bladder of 35 patients and activated using a remote control. The use of a completely intravesical device for the management of anatomic incontinence is a novel approach. The results obtained in pilot studies showed that the device is effective in the management of stress incontinence in patients who were failures after surgery or who refused surgery.