Introduction: Urinary incontinence (UI) is an important clinical problem which affects millions of women worldwide. We describe the Luksenburg system, a minimally invasive procedure for the treatment of UI in women, using platelet-rich plasma (PRP) injections and polycaprolactone (PCL) threads. Material & Methods: A total of 302 patients with UI, mean age 52, were evaluated with detailed history, examination, urinary diary, complete laboratory tests, ultrasonography, urodynamic studies, and completion of International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF). Under local anesthesia, PRP was injected through the anterior vaginal wall, and PCL threads were placed in paraurethral, suburethral, and lateral urethrovaginal spaces, using instruments developed for safe and effective performance. Patients were analyzed at 1, 2, 4, 8 weeks and 6 months posttreatment. Twenty patients were biopsied preoperatively and 60 days after treatment. Results: Symptoms, ICIQ-UI SF score, and postoperative urodynamic studies were significantly improved in 95% of patients with UI grade I, 92% of patients with UI grade II, and in 30% of UI grade III. Biopsies after treatment showed a dense connective tissue 3-dimensional mesh. No complications or adverse effects were observed. All patients declared satisfaction with results, will have the procedure again, and will recommend it. Discussion: The Luksenburg system results in strengthening of the paraurethral, suburethral, and lateral urethrovaginal spaces and the mucosa of the anterior vaginal wall. The combination of PRP injections and the placement of PCL threads create a fibrotic and absorbable mesh-like structure, aimed to increase the urethral resistance, so that under effort the intravesical pressure does not overcome the urethral pressure. Conclusions: These results support that the Luksenburg system is safe and a cost-effective alternative in patients with all grades of UI, reducing the need for invasive surgical procedures.
The worldwide prevalence of female urinary incontinence (UI) is reported at 55%, and about 27% of UIs are severe. The complications in cases of severe UI treated surgically and the ineffective or incomplete results of prolonged treatments with thermal energies motivated us to develop an innovative treatment. Our hypothesis was based on correcting the descent and/or urethral hypermotility and repositioning the descended bladder urethral junction. We have designed a system for the development of a dense and resistant fibrosis that supports the urethra and can correct the alterations of severe UI, Luksenburg systems procedure, LSG3. A group of 652 women between the age of 46 and 74 years, post-menopausal, with more than 2 vaginal births and severe UI, documented by the clinical presentation and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) score index, were enrolled. Originally developed polycaprolactone threads were placed in suburethral space using specific designed tools (LSG3). Immediate results—24 hours (P < .05): 469 patients without clinical UI (72% efficacy), 122 patients with grade 1 UI (drops) (18% improvement), and 59 patients with grade 3 UI (unchanged 9%). Thirty-day results (P < .05): 560 patients without UI (86% efficacy), 58 patients with grade 1 UI (drops) (9% improvement), and 34 patients with grade 3 UI (unchanged 5%). Fifteen-month results (P < .05): 542 patients without UI (83%), 74 patients with grade 1 UI (drops) (11%), and 36 patients with grade 3 UI (6%). No complications or secondary effects were found after the procedure in the 15 months of follow-up. We have developed an innovative system called “suburethral spider web” to treat and cure severe (grade 3) UI in office, as outpatient, that is effective, safe, and cheap.
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