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Surgical interventions for stress urinary incontinence

BMJ 2019; 365 doi: (Published 05 June 2019) Cite this as: BMJ 2019;365:l2350

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Surgical interventions for women with stress urinary incontinence

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What next for transvaginal mesh?

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Re: Surgical interventions for stress urinary incontinence - What about the O-shot?

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: (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.

Competing interests: No competing interests

09 June 2019
Shreelata T Datta
Consultant Obstetrician and Gynaecologist
King's College Hospital
Denmark Hill SE9