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Urinary Incontinence

urinary-incontinence-hero

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

no surgery
no risk
no-laser
no laser vaginal
no hifu vaginal

Advantages of Endopeel vs Other Tools for the Treatment of Urinary Incontinence 

tools for urinary incontinence
advantages-endopeel-vs-other-tools
3D Application for urinary Incontinence

3D Application for Urinary Incontinence

Where to Apply ENDOPEEL

The 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.

muscle puborectalis of the elevator of the anus
deep-transverse-perineum.jpg

Eventual Combination   
Endopeel-Threads

 

In case you add threads, use a resorbable mesh,
in the fatty layer of the urethro-vaginal space.

 
urinary-incontinence-threads
Urethra Anatomy

It is important to remember the anatomy of the urethra

with its 3 layers

  • Mucosa
  • Fatty Layer
  • Muscle Layer

Instrumentation Recommended to use Endopeel in Gynecology

 

fenestrated ( window) vaginal speculum with urethral protection made by Dr.Alain Tenenbaum & Prof.Dr.Mohan Thomas

fenestrated-vaginal-speculum-tenenbaum-thomas

Factors of Success

FACTORS OF SUCCESS IN URINARY INCONTINENCE

Physiopathology of Urinary Incontinence

physiopathology-urinary-incontinence

Diagnosis of the Urinary Incontinence of Effort

  • The Presumptive Diagnosis is based on Clinical Examination
  • The Certainty Diagnosis is based on Urodynamic Examination

Classification of the Urinary Incontinence of Effort

in Different Grades
  • Grade I : Great Efforts
  • Grade II : Moderate Efforts
  • Grade III : Minimum Efforts

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

Movie

Clinical Study

Authors: A.TENENBAUM,M.TIZIANI,& gynecology team

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  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%)

PRP and Urinary Incontinence: A Critical Perspective

Despite widespread marketing claims, Platelet-Rich Plasma (PRP) has no scientifically proven efficacy in the treatment of urinary incontinence. While PRP may enhance superficial tissue trophicity in cases of vulvovaginal atrophy, it does not act on the muscular tone or closure mechanism of the urethral sphincter.

PRP is often promoted by individuals with no formal training in pelvic floor medicine, and in some cases by those with a history of scientific data manipulation. These unproven claims mislead physicians and expose patients to treatments that lack both safety and efficacy.

In contrast, Endopeel has shown consistent and immediate results by increasing the functional tone of both smooth and striated muscles, including the puborectalis, the deep transverse perineal muscle, and the urethral sphincter. This increase in muscular tension leads to effective tightening and improved continence.

Several independent urologists have clinically confirmed the positive impact of Endopeel on urinary control, particularly in cases of stress or mixed incontinence. Unlike PRP, Endopeel works within hours and does not rely on speculative regenerative processes.

We encourage clinicians to remain vigilant and to critically evaluate therapeutic claims, especially when they are linked to commercial interests or unsupported by rigorous, peer-reviewed science.