THE URETHRAL PLUG-II - AN ALTERNATIVE TREATMENT IN WOMEN WITH GENUINEURINARY STRESS-INCONTINENCE

An improved design of the recently developed urethral plug was evaluat ed for the treatment of women with genuine urinary stress incontinence . The plug consists of an oval meatal plate, a soft stalk and 1 or 2 s pheres along the stalk with fixed distances between the meatal plate a nd the spheres. Inside the stalk is a removable semi-rigid guide pin t o ease insertion. Forty women were randomly allocated to treatment wit h either the 2-sphere or the 1-sphere plug during period 1 (2 weeks). In period 2 (2 weeks) the patients used the other plug. They then cont inued with what they judged to be the better plug in period 3 (2 month s). Eighteen patients (45%) completed period 3 with the ''preference'' plug and 17 were subjectively and objectively continent or improved. Fourteen of these women preferred the 2-sphere device. The plugs were equally effective in patients with mild or severe incontinence. To acc ommodate variations in urethral length and to avoid the loss of plugs, the devices are available in different lengths. Six women developed u rinary tract infections and 2 of these had a plug in the bladder. The urethral plug is an effective treatment in a group of women with stres s incontinence. Removal by hand is advisable in order to avoid retenti on of plugs in the bladder.