The minimally invasive method for treatment of stress urinary incontinence in women

Abstract

Urinary incontinence is a complex medical and social problem. Surgical methods designed to treat stress urinary incontinence are expensive and have a number of complications, and existing alternative surgical methods have been ineffective and caused complications due to the very nature of the fillers used. Today, a gel based on hyaluronic acid, DELIGHT® G®, has appeared on the pharmaceutical market, which is injected into the paraurethral area for the purpose of co-opting the urethra. Aim. To develop indications for paraurethral administration of DELIGHT® G® hyaluronic acid-based gel for stress urinary incontinence and to evaluate its effectiveness and safety. Materials and methods. The study involved 35 patients aged 45–55 with mild stress incontinence. Results. The effectiveness of urinary incontinence therapy was 97.1% (n=34). All patients underwent functional tests, uroflowmetry, profilome-try and ultrasound examination of the paraurethral area before and after paraurethral injection of hyaluronic acid-based gel. Uroflowmetry data: before the introduction of the gel, the average value of Qmax 27±1.5 ml/sec and Q average 13.5±2.7 ml/sec, immediately after the paraurethral in-jection of the gel, Qmax 19±2.1 ml/sec and Q average 12.6±1.6 ml/sec and after month Qmax 20±2.3 ml/sec and Q average 11.9±1.9 ml/sec. Profilom-etry data: the average length and functional length of the urethra were 34±0.9 mm and 31±0.8 mm, respectively, which indicates that this study is not informative. According to ultrasound examination of the paraurethral area, after the introduction of a gel based on hyaluronic acid into the paraurethral area, signs of urethral hypermobility and sphincter insufficiency are leveled. Conclusions. Paraurethral injection of hyaluronic acid-based gel can be considered as first-line therapy stress urinary incontinence for patients with initial manifestations of stress urinary incontinence.

Keywords

• stress urinary incontinence
• paraurethral administration
• fillers
• hyaluronic acid
• hypermobility of the urethra
• co-optation of the urethral mucosa.