Treatment of stress incontinence by vaginal cones: short‐and long‐term results and predictive parameters

OBJECTIVE: To evaluate prospectively the short- and long-term results of treatment with vaginal cones for women with urinary stress incontinence and to assess predictive parameters. PATIENTS AND METHODS: Fifty women (mean age 49 years, range 28-76) with differing severities of stress incontinence (mean parity 2.4 and mean 60-min pad-test 20.7 g) were treated with cones for 15 min twice a day for 8 weeks. Treatment results were evaluated immediately after and at a mean of 3 years after the treatment. Parameters were analysed to determine those with predictive value for a successful outcome. RESULTS: Physiotherapy was assessed as being successful, i.e. a complete cure or a reduction of > 50% of the original severity, in seven patients (14%), while in 43 patients (86%) the treatment failed. After 3 years, 13 (30%) reported that the treatment was successful, 27 (61%) reported failure and four (9%) underwent surgery for stress incontinence. Those with lesser amounts of urinary loss and those with less frequent incontinence would be most likely to benefit from treatment with vaginal cones. CONCLUSION: The treatment had a low success rate and we recommend that the vaginal cones should be used only for those with a slight or moderate degree of stress incontinence.