urinary incontinence home

Urinary Incontinence

no surgery
no risk

Objectives

BEFORE 2018 , all treatments were using surgery, laser. HIFU.

Their goal was to correct  THE HYPER URETRAL MOTILITY.

NOWADAYS, we propose less invasive treatments using:

  • ENDOPEEL
  • THREADS
  • PRP
no laser
no laser vaginal
no hifu vaginal

histology and comparaison of vaginal tools

Other Advantages of Endopeel Treatment vs Lasers and HIFU

tools for urinary incontinence
3D Application for urinary Incontinence

3D Application for urinary Incontinence

Where to Apply ENDOPEEL

Goal is to get a 3D isovolumetric myoplasty, myopexy and myotension of the puborectalis of the elevator of the anus and deep transverse of the perineum.

  • on muscle puborectalis of the elevator of the anus

  • on muscle deep transverse of the perineum

Where to apply THREADS

Apply it as a resorbable mesh,in the fatty layer of the urethro-vaginal space.

urethro vesical vaginal space
Urethra Anatomy

It is important to remember the anatomy of the urethra

with it s 3 layers

  • Mucosa
  • Fatty Layer
  • Muscle Layer

Instrumentation Recommended to insert Threads

  • fenestrated ( window) vaginal speculum with urethral protection

  • Bayonets for threads 1 & 2

fenestrated-vaginal-speculum
double fenestrated vaginal speculum

Fenestrated Vaginal Speculum with Urethral Protection

Bayonet 1

Bayonet 1 ( here with thread)

bayonet 2

Bayonet 2 ( here with threads)

How to proceed with threads

introduction bayonet 1 thread

         Introduction of the bayonet with 1 thread

             Introduction of the bayonet with 2 threads

Factors of Success

FACTORS OF SUCCESS IN URINARY INCONTINENCE

Physiopathology of Urinary Incontinence

physiopathology of urinary incontinence

Diagnosis of the Urinary Incontinence of Effort

 

  • The diagnosis of presumption based on clinical examination

  • the diagnosis of certainty is based on the urodynamic examination

Classification of the Urinary Incontinence of Effort in Different Grades

 

  • Grade I : Great Efforts

  • Grade II : Moderate Efforts

  • Grade III : Minimum Efforts


Clinical Study

Authors: A.TENENBAUM,M.TIZIANI,A.LUKSENBURG,J.BARCIA

Study realized between November 2016 till August 2017
on

MATERIAL & METHODS
N=40 female patients
Age Range : 40-62 years old
With 31 patients Grade I
And 9 patients Grade II

ALL TREATED WITH ENDOPEEL-THREADS-PRP as described above 

RESULTS FOR GRADE I

  • Symptomatic improvement at 7 days, 71%, (n = 22)
  • Without incontinence (clinical / urodynamics) at 30 days, 65% (n = 20)
  • Without incontinence (clinical / urodynamics) at 60 days, 97% (n = 30)
  • Treatment failure at 60 days, = 1 case (3%)

RESULTS FOR GRADE II

  • Symptomatic improvement at 7 days 30% (n = 2.7)
  • Without incontinence (clinical / urodynamics) at 30 days, 45% (n = 4)
  • Without incontinence (clinical / urodynamics) at 60 days, 68% (n = 6)
  • Without incontinence (clinical / urodynamic) at 90 days, 89% (n = 8)
  • Treatment failure = 1 case (22%)

Protocol

protocol urinary incontinence

Ultrasonography

ultrasound machine
US-urinary-incontinence

LEGEND:

  • The continuous line marks the horizontal with respect to the pubic

  • the discontinuous line marks the mobility of the urethra, which is obtained from the difference between A and B (rest and effort)

Ultrasonography

VIDEO RESUMING THE PROCEDURE


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