The anti-wrinkle jab which is being used to stop incontinence
21:13 GMT, 26 May 2012
Incontinence: Injections used by cosmetic doctors to smooth out wrinkles are being offered as treatment
Injections like those used by cosmetic doctors to smooth out wrinkles are being offered as a treatment for incontinence.
The jab, containing a gel-like substance similar to a facial filler, is offering patients with severe problems an alternative to surgery.
Stress urinary incontinence (SUI), or bladder weakness, is characterised by involuntary leaking, typically when exercising, coughing or sneezing.
It occurs when the pelvic floor – the muscles that support the bladder – become weak and the bladder neck remains slightly open.
A quarter of women between 30 and 70 have some form of SUI, according to consultant urologist Steve Foley, who has been pioneering the gel at the Royal Berkshire Hospital.
‘All women will be let down by their bladder at some time,’ says Foley, ‘either because of childbirth or the menopause. The design of the pelvic floor is flawed.’
Three levels of treatment are available. ‘We recommend pelvic-floor exercises first,’ says Foley. ‘You have to squeeze the muscles, as though interrupting the flow of urine.’
The next step is usually surgery, which includes mesh tape implants. Having this operation involves a general anaesthetic and six weeks of recovery.
The new injection, Deflux, contains two types of sugar-based molecules – hyaluronic acid and dextranomer. The procedure involves inserting a minute telescope called a cytoscope up the urethra to aid positioning.
Deflux is injected into the urethral wall to provide a cushioning, or bulking, effect. The process is repeated as required – usually two or three times – so it is evenly distributed around the bladder neck. It is available privately and on the NHS.
Botox jab: The injection contains a gel-like substance similar to facial filler but is being used to tackle incontinence
Should it fail to work – success rates are 70 per cent – tape procedures can still be done.
The filler has been successfully used in 200,000 children for the treatment of vesicoureteral reflux, in which urine flows from the urethra to the bladder, leading to possible scarring of the kidneys.
‘It was almost a natural progression to try using the gel for SUI,’ says Foley. ‘The massive advantages are that although it’s a surgical technique there is no cutting, which makes it low-risk. It can be done under sedation or a light general anaesthetic as a day case and patients fully recover within a few days.’
Trudi Shepherd, 51, a dance teacher from Reading, saw her GP last year and was desperate for a solution. She began to develop SUI six years ago. ‘I felt I was leaking constantly. I was really stressed by it,’ she says.
Trudi’s GP recommended pelvic-floor exercises but she was reluctant to see this as a solution. ‘I’m never sure if I’m doing them correctly,’ she says.
She was referred to Foley, who suggested the injections. ‘I had the procedure last June. Although I was warned I might experience some soreness, I felt fine.’
A year later, she is thrilled with the results. ‘It means I don’t have to worry any more.’