A cigarette-sized implant that acts as a one-way valve for the bladder could banish embarrassing leaks in both men and women.
The spring-loaded, tap-like device contains a tiny magnet and is implanted at the junction of the bladder and the urethra (the tube that carries urine out of the body). When the patient needs the loo, they hold a magnetic hand-held controller over their lower abdomen (near the implant site). This magnetically draws the implant towards the device, releasing the spring and opening the valve to allow urine to exit the body.
Once the patient has finished, they flick a switch on the controller to reverse the mechanism, forcing the valve shut again. In tests on ten patients with stress incontinence – where urine leaks out when the bladder is under pressure – volunteers reported an 82 per cent reduction in the number of leaks they suffered after three months of using the device.
Volunteers reported an 82 per cent reduction in the number of leaks after three months
NHS England estimates some 14million Britons suffer with urinary incontinence. Stress incontinence – in which leaks can also be triggered by the patient coughing or laughing – accounts for around 40 per cent of cases. It’s mostly due to weakening of the pelvic floor muscles that control urination.
Risk factors in women include pregnancy and vaginal birth, which ‘stretches’ pelvic floor muscles. In men, however, it’s mostly due to prostate cancer surgery (which can damage the nerves controlling the pelvic floor muscles).
Current treatments include exercises to strengthen pelvic floor muscles, and an antidepressant – duloxetine – can also boost the muscle tone of the urethra, helping to keep it closed.
Some people undergo surgery to support the bladder neck. Previously, this often utilised a vaginal mesh, but its use on the NHS is now limited following serious complications in some women.
But the new implant, which takes just ten minutes to insert under local anaesthetic, could be a simpler and more effective solution in both men and women.
Doctors feed a thin tube, also known as a catheter, via the urethra to its junction with the bladder. They then push the cylindrical implant – just 3cm long and 0.7cm wide – through, securing it in place with a metal tube (or stent).
The device works when opposite poles of the magnets inside the body and the hand controller attract, opening the valve to allow urine to pass through the urethra. When the poles are switched in the controller, however, the magnets repel each other, shutting the valve and stopping leaks.
A report in the Journal of Endocrinology by researchers from several centres in Italy – including Rome University, which developed the implant – said it led to ‘remarkable improvements’ in symptoms.
Commenting on the implant, Professor Raj Persad, a consultant urologist at Bristol Urology Associates, said: ‘This device is ingenious and very promising.
‘Clearly, the trialists need to be vigilant before marketing the device, and issues that might alter the dynamics of the device – such as ageing of the tissues and weight gain – should be borne in mind.’
