A multicentre evaluation of a new surgical technique for urethral bulking in the treatment of genuine stress incontinence

This prospective study assesses the surgeon and patient acceptability of a new implantation device for transurethral Macroplastique injection, as well as the safety and effectiveness of the technique. Ten women with genuine s tress incontinence were recruited at each of four participating urogynaecol ogical centres. Treatment was performed in an outpatient or day case settin g and follow up took place at six weeks and three months after treatment. T hose in whom treatment had failed were offered re-treatment. The operator a cceptance of the device was rated as excellent or acceptable in 95% after t he first treatment and 100% after re-treatment. Urethral insertions were ra ted acceptable in 92.5%. Pain was scored as mild to moderate in 89% of all insertions. The overall success rate was 74.3% at three months with an impl antation rate of 1.35 which appears to be comparable to published endoscopi c data. We have concluded from this study that the Macroplastique implantat ion device is safe to use and provides simplified, yet effective alternativ e to the endoscopic implantation of urethral bulking agents.