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Urethral Opening Occlusion Devices

There are several new non-surgical products on the market for female stress urinary incontinence. Brand names are listed:

• Capsure® and Femassist®. – This type of device creates enough suction to keep the walls of the urethra together during stressful activities where someone might otherwise leak. The patient places a small amount of Vaseline-like material on the suction cup and places it in the area of the urethral opening, which is just above the vaginal opening. The placement does not have to be exact and once the device is in place the labia fold over it and the device cannot be seen or felt. When the patient needs to urinate, the suction cup is easily pulled off. The device is washed with soap and water and dried and is re-usable.
• Reliance® – is an inter-urethral insert. This product requires the patient to insert a small catheter/plug into the urethra (tube that the urine travels through from the bladder to the toilet). These devices are comfortable to wear and when the patient needs to urinate, she pulls on a string, much like a tampon, to remove the device. When finished urinating, a new device is replaced in the urethra. There is a higher rate of urinary tract infections with this product versus the ones listed in the prior paragraph.
• Tampons – can also be used for stress incontinence activity based leakage. Placing a tampon in the vagina acts as a support or buttress for the urethra and bladder. Supporting this area can reduce urine leakage with coughing, sneezing, bearing down (Valsalva maneuver) or exercising.

Comparing sizes – Q-Tip, tampon, and Reliance® urethral insert.

Collagen Injections

Collagen is a naturally occurring protein found in humans and animals. When it is injected into the tissue around the urethra, it adds bulk and helps it close tightly to prevent urine leakage, especially urine leakage associated with activity (Stress Urinary Incontinence). Most patients will leak much less or not leak at all after collagen therapy. Some patients will need to have one or more injections done at a later date because the body will absorb some of the collagen material. The length of time between injections varies with each patient. Some need to be re-injected after a few months and some after a few years.

Collagen Injection – The white area is the collagen and it is obvious how its injection and bulk pushes the urethra closer together giving a tighter urethra and ultimately less leakage.

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Incontinence Treatment