Factsheet: Urethral insert devices for men with urinary incontinence
The following factsheet can also be found for download at: https://www.canadiancontinence.ca/pdfs/EN-Factsheet-Urethral-inserts-for-men-2020-02.pdf
Men who are leaking urine from the bladder (i.e. urinary incontinence or UI) following prostate surgery typically have what is called stress (or exertional) UI. Stress UI is leakage of urine when pressure is exerted on the bladder – for example with exercise, bending over, or lifting something heavy. This is due to weakness of the sphincters at the bottom of the bladder which can be damaged by the surgery.
Conservative methods of managing stress UI include pelvic muscle exercises and bladder retraining. If these therapies are not effective, men are left with four non-surgical choices to manage their incontinence: absorbent products (diapers or pads), urethral inserts, external collection devices (e.g. a condom catheter with leg bag drainage), and penile compression devices. Some men elect to pursue further surgery, a sling operation or implantation of an artificial sphincter.
Urethral inserts are temporarily inserted into the urethra (the tube which carries urine from the bladder to the outside of the body) to prevent or reduce bladder leakage. Inserts are removed prior to urination, reinserted after voiding, generally re-usable, and are made of soft medical-grade plastic which causes little discomfort.
In a five-year multi-site Canadian clinical study1 in 36 men with stress incontinence, the Contino® urethral insert demonstrated significant reduction in the amount of urine leakage, as measured by a change in pad weight and in the severity of UI, as measured using the International Consultation on Incontinence Questionnaire – Short Form. In particular, some participants experienced a reduction in urine loss in excess of 95% of total daily loss. Adverse events were minor, predictable and either self-limiting or easily treated. All were resolved prior to the end of the study and virtually all within the first week. The most common adverse events were mild bleeding (7 instances) and pain (10 instances) on initial insertion, which were expected during the training process.
It is important to consult with a health care professional about the correct type, size and placement of the device. Although there may be some initial discomfort when inserting or removing the device, this should pass after the first few weeks of use when using a properly sized device.
Fig A: Illustrative example of a urethral insert in situ
A Prospective, Non-Randomized, Single Armed Trial to Assess the Efficacy of the Contino® urethral insert in Preventing UI in Male Subjects with Sphincteric Incompetence. Dr. Casey, CMO of CMX Research Inc., was the Principal Investigator and Life360 Innovations Inc. was the sponsor. https://www.isrctn.com/ISRCTN81411507. Additional information is available at mycontino.com.