Urethral Devices

Urethral devices may be worn external to the urethral meatus or inserted into the urethra. These devices are contraindicated in patients with bladder or urethral cancer, urinary tract infection, interstitial cystitis, neurogenic bladder, and in those at risk for endocarditis. Patients with limited manual dexterity may have difficulty using them.

The FemAssist device (Insight Medical, Bolton, MA) is a dome-shaped urethral cap made of silicon. It is placed over the urethral meatus with mild suction. This creates a watertight seal between the device and the urethra. The device may be worn for up to 4 hours. When the patient wishes to void, she releases the vacuum seal. It may be washed and worn for up to a week. Trincello et al.7 reported a significant reduction in the volume of urine loss, and a 56% satisfaction rate. Rabin8 did not find significant urinary tract infection rates or bacteriuria, and noted that the patients were dry 82% of the time.

The urethral patch (UroMed) is another external ure-thral barrier. It is a single-use foam pad that is coated with an adhesive and fits over the urethral meatus, providing opposing pressure and a barrier to leakage. The patch is removed for urination. Women who used this device reported a significant decrease in urinary leakage and an improvement in their quality of life.9

Other devices are inserted into the urethra. The FemSoft (Rochester Medical Corp., Stewartville, MN) insert is a sil-icone catheter encased in an oil-filled sleeve that has a balloon on its tip. When the FemSoft is placed into the urethra, it conforms to the urethra to decrease incontinence. The device is a sterile, single-use product that is removed and discarded when the patient voids. Women using the device had significantly less urinary leakage, and the majority of them were satisfied with the product. There was, however, a 25% rate of urinary tract infections.1

The Reliance Urinary Control Insert (UroMed), or urethral plug, is a single-use, balloon-tipped cylinder that is inserted into the urethra. The air-filled balloon holds the device in place and prevents incontinence. In order to void, a string is pulled to deflate the balloon. This insert is also a single-use, disposable item. Patients who used this device had an 89% subjective success rate, 31% incidence of infection, and a 21% incidence of gross hematuria.10 Another urethral insert, the Viva urethral plug, had a 33% to 43% success rate. This device was also associated with urinary tract infection and was hindered by plug migration to the bladder.2

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Responses

  • azzeza
    Are internal urethral device on prescription?
    26 days ago

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