A plastic plug could help treat incontinence in men who’ve undergone prostate surgery
A plastic plug could help treat incontinence in men who’ve undergone surgery to remove the prostate gland.
Designed and developed by a prostate cancer patient left incontinent after the operation, the plug is now being tested in a clinical trial in Canada.
The problem occurs as a result of nerves and muscles that control the bladder becoming damaged during the operation, with approximately one in five prostate cancer patients thought to experience leaks in the long-term as a result.
The most common problem is stress incontinence, meaning men leak when they cough, sneeze or exercise. This occurs because of damage to the muscular valve — the bladder sphincter — that keeps urine in the bladder. Treatment includes pelvic floor exercises, to improve muscle tone and support the bladder neck, or even surgery to fit implants to take pressure off the valve.
The new device — which is being tried by 30 patients in five hospitals across Canada — involves placing a plug into the urethra to physically stop any leakages.
The device, called the Comfort Plug, looks like a tiny, tapered spinning top and is made from a soft plastic.
It is said to be painless to use and is inserted into the urethra by the patient themselves, using a thin stick that clips on to the top of the plug.
The plug is pushed until it reaches an area called the bulbar urethra, which is around 2-3cm in length, between the sphincter and the base of the penis.
The plug is kept in place all day and the user can simply remove it when they need to go to the loo.
Patients are given guidance on how to insert, remove and clean the plug.
Men in the new trial will use the plug for 30 days and keep a diary to document how often the plug is removed and any leakages.
They will also wear pads, which will be weighed to measure leakages.
Relief: The device, called the Comfort Plug, looks like a tiny, tapered spinning top and is made from a soft plastic
Professor Raj Persad, a consultant urologist with Bristol Urology Associates, says he welcomes the device as a possible treatment, as there is so little else on offer for men with stress incontinence.
‘Most other treatments to date are invasive and require a general anaesthetic,’ he says.
‘This plug may well be a solution for milder degrees of incontinence and, having been designed by a patient, gives one more confidence that it will be acceptable to other patients. One factor of importance is the varying degree of sensitivity encountered in the urethra and a theoretical risk of infection if not cleaned correctly.
‘I would be happy to trial this in the UK with our patients.’
Meanwhile, high-intensity exercise is being investigated as a way to extend the life expectancy of those men with advanced prostate cancer.
In a three-year study overseen by the University of Surrey, 866 men in Australia, North America and Europe will be split into two groups.
One will do high- intensity interval training — or HIIT — (bursts of intense cardio exercises lasting minutes, followed by rest periods) three times a week and will be sent some motivational texts.
The other group will stick to their normal lifestyles.
The researchers will measure factors such as the use of pain medications, survival time and levels of inflammation markers in the blood.
The researchers say that if the study shows HIIT can extend lifespan and improve mental and physical wellbeing for these patients, then it could have a ‘revolutionary’ effect on the treatment of prostate cancer in the future.