Posted by mitch11 on June 07, 2001 at 12:30
Reliant is a three wheel car and a ride in it is a cure for a tight bladder if ever there was one - or so I'm told. Here's the info. somebody asked for a while ago:
October 1997
Technology Assessment
Recent Advances in Conservative Therapies for the Treatment of Stress Urinary Incontinence
Jeffrey A Dann
University of Massachusetts, Worcester, Massachusetts, USA
Approximately 17% of all adult women over the age of 35 suffer from some degree of
urinary incontinence. The American Foundation for Urologic Disease (AFUD) has found that in women with stress urinary incontinence (SUI):
49% utilise two pads or less per day
90% initially decide upon a nonsurgical treatment
48% are dissatisfied with the current treatment options
60% would try a new nonsurgical treatment if offered.1
Because of overwhelming market demand, there has been a focused effort by the
urological community and industry to develop a simple, noninvasive, "low technology" alternative to treat SUI.
Noninvasive Treatments for Stress Urinary Incontinence
The three basic classes of noninvasive devices are as follows:
Intraurethral plugs
Intraurethral plugs are small, indwelling urethral catheters which reduce SUI by obstructing urine flow. The Reliance® device (Uromed Inc., Needham, MA, USA)
consists of a small disposable balloon-tipped intraurethral catheter. The balloon is
inflated and rests on the bladder neck, preventing urinary leakage. When a woman desires to void she simply removes the device by pulling on an attached string which deflates the balloon. Results from a US multicentre trial demonstrate that 79% of patients are dry with the Reliance device. Adverse effects during this 4-month trial included a 31% incidence of urinary tract infections (11% asymptomatic and 20% symptomatic), 21% of gross haematuria and 67% of initial foreign-body sensation or vaginal discomfort which decreased to 13% by the end of the trial.2 Furthermore, the potential economic impact of this single-use disposable product to the patient and healthcare system can be enormous.
Newer, more exotic intraurethral plugs have attempted to incorporate a valve mechanism into a nondisposable device design. The Influence device (Influence Inc., San Francisco, CA, USA) is a transurethral tube with a remotely activated valve, while the Autocath® 100 (HK Medical Technologies, TX, USA) has a pressure-sensitive valve control which is triggered to open by intra-abdominal muscle straining. Both are currently undergoing clinical trials to define their efficacy and safety, especially with regard to the high incidence of urinary tract infections and foreign-body sensation anticipated in any indwelling urethral device.
Meatal suction-occlusion devices
The newest, most intriguing noninvasive modality for the treatment of SUI is the meatal suction-occlusion device (NEBL, Worcester, MA, USA). These devices are uniquely designed suction cups made of medical grade silicone or thermoplastic material (Figure 1). When placed over the urethral meatus, these devices create a measured amount of negative pressure which, in turn, causes coaptation of the urethral sidewalls and increased urethral resistance.
Figure 1. Meatal suction-occlusion device (NEBL Inc)
Physiologically, these devices appear to reproduce and augment natural sphincter
function as the urethral lumen is occluded from the negative pressure. To improve mechanical function, a biocompatible application such as KY jelly, Vaseline or Aquaphor is used on its rim. The device is removed when the patient needs to void, and then replaced. A US multicentre trial is currently evaluating the safety and efficacy of the device.
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