Project Overview

Urinary leakage affects more than half of independent US women aged 65 and older (Gorina), and its direct health care costs exceed $25 billion annually (Miner). Stress urinary incontinence, the leakage of urine associated with activities that increase intra-abdominal pressure such as coughing, sneezing, and lifting, can be treated with surgery, pelvic floor muscle strengthening, or the use of an intra-vaginal silicone support device called a pessary.

Pessaries are traditionally used to treat relaxation of the vaginal walls (pelvic organ prolapse) and thus sit between the apex of the vagina and the back of the pubic bone, supporting the vaginal apex and anterior wall. Historically, it was believed that loss of support of the bladder neck (the junction between the bladder and the urethra, tube through which urine leaves the bladder) contributed to stress incontinence. Therefore, two pessaries were designed specifically to treat stress incontinence: an incontinence ring and an incontinence dish. These pessaries sit between the apex of the vagina and the pubic bone and each has a knob to support the bladder neck, but neither incorporates a mechanism to prevent rotation of the knob from midline, and they improve symptoms for about 50% of women who try them. In contrast, mid-urethral sling surgery to treat stress incontinence results in improvement or cure in over 90% of women who undergo the procedure.

Over the last twenty years, our understanding about the underlying pathophysiology of stress incontinence has evolved (Delancey). The purpose of this project is to build an innovative pessary that provides a minimally invasive and more effective alternative to surgery for the treatment of stress urinary incontinence.


References:

Delancey, J., & Ashton-Miller, J. "Pathophysiology Of Adult Urinary Incontinence." Gastroenterology 126 (2004): S23-32. Web: http://www.ncbi.nlm.nih.gov/pubmed/14978635.

Miner, P.B. Jr. "Economic and Personal Impact of Fecal and Urinary Incontinence." Gastroenterology 126 (2004): S8-S13. PubMed. Web: http://www.ncbi.nlm.nih.gov/pubmed/14978633.

Gorina, Y., Schappert, S., Bercovitz, A., Elgaddal, N., & Kramarow, E. "Prevalence of Incontinence Among Older Americans." Vital Health Stat. 3.36 (2014): 1-15. PubMed. Web: http://www.ncbi.nlm.nih.gov/pubmed/24964267.

Cameron, A.P., & Haraway, A.M. "The Treatment of Female Stress Urinary Incontinence: An Evidenced-based Review." Open Access J Urol. 3 (2011): 109-120. PubMed Central. Web: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3818941.

Oliver, Reeba, Ranee Thakar, and Abdul H. Sultan. "The History and Usage of the Vaginal Pessary: A Review." Eur J Obstet Gynecol Reprod Biol. 156 (2011): 125-30. PubMed. Web: http://www.ncbi.nlm.nih.gov/pubmed/21255901.

Image

Contact Information

Team Members

• Joshua Plantz - Team Leader
• Jack Mcginnity - Communicator
• Ping Hu - BSAC
• Thomas Feustel - BWIG
• Mufaddal Lakdawala - BPAG

Advisor and Client

• Prof. Naomi Chesler - Advisor
• Dr. Gloria Sarto - Client

Related Projects

• Spring 2018: SLIP project (Solution for Leakage through an Innovative Pessary)
• Fall 2017: SLIP project (Solution for Leakage through an Innovative Pessary)
• Spring 2015: SLIP project (Solution for Leakage through an Innovative Pessary)
• Fall 2014: Solution for Leakage through an Innovative Pessary (SLIP) Project