New pessary gives bladders a boost

By Suzanne Rent
Thursday, November 30, 2006

Halifax doc's device update puts incontinence control in women's hands

In his 17 years practising urogynecology, Halifax physician Dr Scott Farrell has seen many women suffering with bladder incontinence. He says while there are some options available to women, including exercise, drugs and surgery, most continue to suffer without treatment. So in 2002, he set out to help women with incontinence — particularly stress incontinence — by creating a new design of an old idea: the pessary.

"It's estimated one in three women worldwide have incontinence and probably about three-quarters of those have stress incontinence, so it's very widespread," says Dr Farrell. "I've used pessaries now for close to 10 years and found that they've actually worked quite well for women. They're a nice conservative option that women can use as an alternative to surgery."

But Dr Farrell says traditional ring-shaped pessaries — which resembled diaphragms — have a few drawbacks that make them unappealing. For one, they have to be manipulated and folded for insertion and removal. Also, if the knob on the design, which is meant to support the bladder, isn't properly placed, it won't support the bladder, and therefore the leakage continues. Thirdly, they have to be fitted by a healthcare professional.

"We know from studies that women would like to self-manage this problem," says Dr Farrell, "and the only self-management option out there now is absorbent pads, which they can get at a pharmacy. And they don't solve the problem, they just cover it up."

NEW & IMPROVED
The design of Dr Farrell's pessary — which will be marketed under the name Uresta through Halifax firm EastMed — is considerably different. It's shaped like a bell and works much like a tampon. The new pessaries will be sold in a set of three different sizes, so women can choose the size that works best. And like absorbent pads, they'll be available over the counter.

The pessary is made from a medical-grade rubber, similar to the material used in those traditional pessaries. The Uresta pessary sits underneath the urethra and provides mechanical support. "It's a similar principle to surgery. Surgeries are designed to do exactly that, provide support to the urethra to stop the leaking," says Dr Farrell.

The Uresta pessary was tested at the IWK Health Centre in Halifax. About two-thirds of the 32 subjects were fitted for a pessary, and, of that group, 75% completed the year-long trial and still use the product.

ONE HAPPY PATIENT
Forty-five-year-old Vicki (not her real name) was one of the women who took part in the trial. She says she's had bladder incontinence for as long as she can remember, and used pads to deal with the problem. That option, she says, was "pretty costly, not to mention embarrassing." She says the pessary was a far better solution for her than surgery. "I wouldn't have taken that step. Something like this, that's not invasive, was more attractive," she says.

She noticed the difference immediately and now uses her pessary all the time. "It's comfortable — you don't even know it's there," she says. "And I don't have to buy those thick pads anymore!"

EastMed hopes to have Health Canada approval to sell the device by September. An education campaign for doctors and pharmacists is also planned. But ultimately, Dr Farrell says, it's all about his patients. "This is a quality-of-life product," he says. "Our goal is to help women to take control of their bladders again and to resolve an issue that is widespread."

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