A cigarette-sized implant that acts as a one-way valve for the bladder could eliminate embarrassing leaks in both men and women.
The spring-loaded, faucet-like device contains a small magnet and is implanted at the junction of the bladder and urethra (the tube that carries urine out of the body). When the patient needs to go to the bathroom, he or she holds a handheld magnetic controller over the lower abdomen (near the implant site). This magnetically attracts the implant to the device, releasing the spring and opening the valve to allow urine to leave the body.
Once the patient has finished, he flips a switch on the controller to reverse the mechanism, forcing the valve to close again. In tests on ten patients with stress incontinence (where urine leaks when the bladder is under pressure), volunteers reported an 82 percent reduction in the number of leaks they suffered after three months of using the device.
The volunteers reported an 82 percent reduction in the number of leaks after three months.
The National Health Service in England estimates that around 14 million Britons suffer from urinary incontinence. Stress incontinence, in which leaks can also be caused by the patient’s coughing or laughing, accounts for about 40 percent of cases. It is mainly due to the weakening of the pelvic floor muscles that control urination.
Risk factors in women include pregnancy and vaginal birth, which “stretch” the pelvic floor muscles. In men, however, it is mainly due to prostate cancer surgery (which can damage the nerves that control the pelvic floor muscles).
Current treatments include exercises to strengthen the pelvic floor muscles and an antidepressant (duloxetine) can also increase the muscle tone of the urethra, helping to keep it closed.
Some people have surgery to support the neck of the bladder. Vaginal mesh was previously often used, but its use in the NHS is now limited due to serious complications in some women.
But the new implant, which is inserted in just ten minutes under local anesthesia, could be a simpler and more effective solution for both men and women.
Doctors insert a thin tube, also known as a catheter, through the urethra to where it joins the bladder. They then push the cylindrical implant (just 3 cm long and 0.7 cm wide) and secure it in place with a metal tube (or stent).
The device works when the opposite poles of the magnets inside the body and the hand controller attract, opening the valve to allow urine to pass through the urethra. However, when the poles are switched on the controller, the magnets repel each other, closing the valve and stopping leaks.
A report published in the Journal of Endocrinology by researchers from several centers in Italy – including the University of Rome, which developed the implant – said it led to “remarkable improvements” in symptoms.
Professor Raj Persad, Consultant Urologist at Bristol Urology Associates, commented on the implant: “This device is ingenious and very promising.
“Clearly, researchers must be vigilant before commercializing the device and must take into account issues that could alter the dynamics of the device, such as tissue aging and weight gain.”