BNT: Bladder Neck Threads

A simple cure for stress urinary incontinence.

Philippe Sarouphim*

Corresponding Author: Philippe Sarouphim MD, Private Medical Center. 

Copy Right: © 2022 Philippe Sarouphim. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received Date: January 21, 2022

Published Date: February 02, 2022

Introduction

Needle bladder neck suspensions (modified Pereyra and Stamey type) have been used for a long time with success up to 80%. They are invasive, have many complications and need regional anesthesia at best. Barbed threads are used in cosmetic facial procedures to lift the cheeks, neck, and eyebrows. We use barbed threads in our center for cosmetic purposes and came up with a new procedure to lift the urethra in an inverted needle insertion technique using the anchorage at the prepubic periosteum.

Design

Patients with stress urinary incontinence have been selected after their clinical assessment, questionnaire and urinary voiding charts and consented to have a BNT. All patients were informed that this is a new pilot study using barb threads instead of the mesh (TVT or TOT) to treat their SUI. They were also aware of the similarity with the Pereyra procedure and its published success rates. The threads were placed in a semi sterile operating room at our center under local anesthesia as shown in the video. 

We chose the Bidirectional barb threads to have a better anchorage at each side of the distal urethra avoiding any passage under the urethral tissue, therefore, bypassing all complications like erosions and urinary retention. The prepubic placement avoids bladder injuries and the need for cystoscopy.

Results

BNT seems very promising.

In the first 10 cases that we performed we have had no complications and all patients have reported major improvement in their continence. 3 out of 10 patients reported pubic and vulvar discomfort that resolved in a few weeks.

Conclusion

This new procedure is simply effective and seems very successful as the barb threads stay in place and their anchors do lift the bladder neck to its original place. At one year we do not have any recurring patients and in our opinion, a BNT can be added to our armamentarium for mild and moderate S U I.

More cases are needed to check for the longevity and the fibrosis that keep the patients continent.