Endoscopic correction of intractable stress incontinence with silicone micro-implants.

Abstract

To assess the clinical value of silicone micro-implants (Macroplastique, Uroplastique, Bioplastique) in the treatment of intractable genuine stress incontinence. Between January 1992 and March 1995, 34 patients with failed previous surgery for genuine stress incontinence were treated with transurethral submucosal injection of Macroplastique. 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. 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.