L Mouritsen1. 1. Department of Obstetrics and Gynecology, Gentofte Hospital, University of Copenhagen, Denmark.
Abstract
OBJECTIVE: To evaluate how vaginal continence products affect the bladder neck mobility and ability to contract the pelvic floor muscles. MATERIAL AND METHODS: Fifteen stress incontinent women with leakage >8 g/24 hours were assessed by a questionnaire, 24 hours pad test and vaginal ultrasonography of bladder neck position and mobility. The patients were examined without any device, with a commercially available device (Conveen Continence Guard, CCG, Coloplast A/S) and two new shaped test models (TM I/II). Bladder neck position was measured in relation to the midline of the pubic symphysis at rest, Valsalva and squeezing. RESULTS: About two-thirds of the women became subjectively continent with the device. The mean leakage per 24 hours was reduced 87% (61-96%) with a vaginal device. No difference was found between the effect of old and new product. Evaluated by ultrasonography, the devices worked by supporting the bladder neck and reduced the mobility from 34 degrees to 18 degrees with CCG and to 15 degrees with TM. Neither CCG nor TM had any adverse effect on the ability to elevate the bladder neck during squeezing. CONCLUSIONS: Vaginal devices are effective in alleviating stress incontinence and work by supporting a hypermobile bladder neck. The devices had no negative effect on the ability to contract the pelvic floor muscles. Ultrasonography is a fast and low invasive method to study effect of vaginal devices both in the individual patient and for testing new products.
OBJECTIVE: To evaluate how vaginal continence products affect the bladder neck mobility and ability to contract the pelvic floor muscles. MATERIAL AND METHODS: Fifteen stress incontinentwomen with leakage >8 g/24 hours were assessed by a questionnaire, 24 hours pad test and vaginal ultrasonography of bladder neck position and mobility. The patients were examined without any device, with a commercially available device (Conveen Continence Guard, CCG, Coloplast A/S) and two new shaped test models (TM I/II). Bladder neck position was measured in relation to the midline of the pubic symphysis at rest, Valsalva and squeezing. RESULTS: About two-thirds of the women became subjectively continent with the device. The mean leakage per 24 hours was reduced 87% (61-96%) with a vaginal device. No difference was found between the effect of old and new product. Evaluated by ultrasonography, the devices worked by supporting the bladder neck and reduced the mobility from 34 degrees to 18 degrees with CCG and to 15 degrees with TM. Neither CCG nor TM had any adverse effect on the ability to elevate the bladder neck during squeezing. CONCLUSIONS: Vaginal devices are effective in alleviating stress incontinence and work by supporting a hypermobile bladder neck. The devices had no negative effect on the ability to contract the pelvic floor muscles. Ultrasonography is a fast and low invasive method to study effect of vaginal devices both in the individual patient and for testing new products.
Authors: Gabriel Francisco Aleixo; Marcelo C M Fonseca; Maria Augusta Tezelli Bortolini; Luiz Gustavo O Brito; Rodrigo A Castro Journal: Int Urogynecol J Date: 2018-11-22 Impact factor: 2.894
Authors: Helga Gimbel; Vibeke Zobbe; Birthe Jakobsen Andersen; Helle Christina Sørensen; Kim Toftager-Larsen; Katrine Sidenius; Nini Møller; Ellen Merete Madsen; Mogens Vejtorp; Helle Clausen; Annie Rosgaard; John Villumsen; Christian Gluud; Bent S Ottesen; Ann Tabor Journal: Int Urogynecol J Pelvic Floor Dysfunct Date: 2005 Jul-Aug