Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles.
I was disappointed to read Carter and Cartwright’s commentary on surgical interventions for stress urinary incontinence, given the intraoperative and postoperative risk of complications and the national drive towards office based treatments (Datta 2015). One novel intervention which is not considered is platelet rich plasma therapy, an outpatient treatment which uses platelet rich plasma, an inexpensive biological material, produced directly from the patient’s blood, therefore minimising a reaction. This is already used to treat tendinopathy and osteoarthritis successfully and has been found to be a safe and effective option for women with stress incontinence (Neto JB 2017, Nikolopoulos 2016). As such, it should be discussed and potentially offered to suitable women as alternative to surgery, rather than limiting them to the conventional therapies we are comfortable with only.
Datta S Day case surgery: not the whole answer to the NHS’s increasing demand for operations
BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h4877 (Published 17 September 2015)
Neto JB J O-Shot: Platelets Rich Plasma in Intimate Female Treatment Women's Health Care 2017, Vol 6(5): 395
Nikolopoulos KI, Pergialiotis V, Perrea D, Doumouchtsis SK Restoration of the pubourethral ligament with platelet rich plasma for the treatment of stress urinary incontinence. Med Hypotheses. 2016 May;90:29-31. doi: 10.1016/j.mehy.2016.02.019. Epub 2016 Mar 2.