Device
to Treat Urinary Stress Incontinence Eliminates Need for Abdominal
Incisions: Emory gynecologist one of two Georgia physicians using
Capio CL device
Of the 13 million
people in the United States who experience urinary incontinence, the
vast majority are women. Stress urinary incontinence is the most common,
but treatable, form of incontinence in women. It surfaces as a result
of physical changes during pregnancy, childbirth, menopause or aging.
Traditional surgical treatments
use both a transvaginal approach and abdominal incisions to insert a
sling under the weakened or damaged urethra. But a device used by an
Emory gynecologist eliminates the need for additional abdominal incisions,
thus affording the patient a shorter recovery period.
Rony Adam, M.D., assistant
professor, Department of Obstetrics and Gynecology, University School
of Medicine, is one of two Georgia physicians currently using the Capio
CL — a device that allows attachment of a supportive sling to Cooper's
ligament through the vagina. The Capio CL is designed to throw, capture
and retrieve suture through Cooper's ligament with the press of a single
button. Additionally, the device is equipped with an indicator to align
the device with the patient's anatomy and a rotating head to assist
with positioning.
"By eliminating the abdominal
incision, the Capio CL not only shortens the patient's hospital stay,
but decreases her chances for infection," Dr. Adam says. "Mild cases
of surgical wound infection mostly cause discomfort and additional costs
since dressing changes are often needed several times a day. Cases of
deep infection can be life threatening and always requires additional
surgery to manage."
In people with stress incontinence,
the pelvic floor muscles and ligaments that support the vagina weaken
and fail, which may cause the bladder to push downward toward the bottom
of the pelvis. Physical stress such as coughing, sneezing, laughing,
bending or lifting, puts pressure on top the bladder and the urethra
is unable to stay closed, resulting in stress incontinence. Consequently,
urine leaks through the urethra (the tube through which urine leaves
the body).
A particularly difficult
type of stress incontinence to treat is termed "intrinsic sphincter
deficiency" (ISD). Patients with ISD are particularly likely to benefit
from suburethral sling procedures.
The Cooper's Ligament, located
at the top of the pubic area, is frequently used by physicians as a
fixation point when operating on women with stress incontinence. Suburethral
slings are made from the patient's own body tissue or a strip of synthetic
or processed biologic material. When suspended between both Cooper's
ligaments, the sling forms a hammock-like structure to support the urethra
and bladder neck thus restoring continence.
"Sling procedures to cure
stress incontinence are effective in about 90-95% of patients," Adam
says.
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