Left: Uresta, Dr Farrell's
update of the pessary
Right: Halifax urogynecologist Dr Scott Farrell
Photos courtesy EastMed
In his 17 years practising urogynecology,
Halifax physician Dr Scott Farrell has seen many women
suffering with bladder incontinence. He says while there
are some options available to women, including exercise,
drugs and surgery, most continue to suffer without treatment.
So in 2002, he set out to help women with incontinence
particularly stress incontinence by creating
a new design of an old idea: the pessary.
"It's estimated one in three women
worldwide have incontinence and probably about three-quarters
of those have stress incontinence, so it's very widespread,"
says Dr Farrell. "I've used pessaries now for close
to 10 years and found that they've actually worked quite
well for women. They're a nice conservative option that
women can use as an alternative to surgery."
But Dr Farrell says traditional
ring-shaped pessaries which resembled diaphragms
have a few drawbacks that make them unappealing.
For one, they have to be manipulated and folded for
insertion and removal. Also, if the knob on the design,
which is meant to support the bladder, isn't properly
placed, it won't support the bladder, and therefore
the leakage continues. Thirdly, they have to be fitted
by a healthcare professional.
"We know from studies that women
would like to self-manage this problem," says Dr Farrell,
"and the only self-management option out there now is
absorbent pads, which they can get at a pharmacy. And
they don't solve the problem, they just cover it up."
The design of Dr Farrell's pessary which will
be marketed under the name Uresta through Halifax firm
EastMed is considerably different. It's shaped
like a bell and works much like a tampon. The new pessaries
will be sold in a set of three different sizes, so women
can choose the size that works best. And like absorbent
pads, they'll be available over the counter.
The pessary is made from a medical-grade
rubber, similar to the material used in those traditional
pessaries. The Uresta pessary sits underneath the urethra
and provides mechanical support. "It's a similar principle
to surgery. Surgeries are designed to do exactly that,
provide support to the urethra to stop the leaking,"
says Dr Farrell.
The Uresta pessary was tested at
the IWK Health Centre in Halifax. About two-thirds of
the 32 subjects were fitted for a pessary, and, of that
group, 75% completed the year-long trial and still use
Forty-five-year-old Vicki (not her real name) was one
of the women who took part in the trial. She says she's
had bladder incontinence for as long as she can remember,
and used pads to deal with the problem. That option,
she says, was "pretty costly, not to mention embarrassing."
She says the pessary was a far better solution for her
than surgery. "I wouldn't have taken that step. Something
like this, that's not invasive, was more attractive,"
She noticed the difference immediately
and now uses her pessary all the time. "It's comfortable
you don't even know it's there," she says. "And
I don't have to buy those thick pads anymore!"
EastMed hopes to have Health Canada
approval to sell the device by September. An education
campaign for doctors and pharmacists is also planned.
But ultimately, Dr Farrell says, it's all about his
patients. "This is a quality-of-life product," he says.
"Our goal is to help women to take control of their
bladders again and to resolve an issue that is widespread."