Urethral Bulking Injection
What is a Urethral Bulking Injection?
This is an operation to treat stress incontinence (leakage of urine when you exercise, sneeze or strain). The operation involves injecting a bulking agent into the wall of your urethra (tube that carries urine) using a small telescope to treat symptoms.
The bulking agent helps the urethra to make a watertight seal and to prevent urine leaking from your bladder.
Source: Chapple, C., & Dmochowski, R. (2019). Particulate Versus Non-Particulate Bulking Agents In The Treatment Of Stress Urinary Incontinence. Research and reports in urology, 11, 299–310.
How
effective is
the procedure in curing stress urinary incontinence?
About 7 out of 10 women have much less leaking or stop leaking altogether after this treatment.
However, some women may start to leak urine again at a later stage and may need either further injections or another type of operation. In the longer term, 50% (half) of women treated by urethral bulking will have a successful outcome.
How is the procedure performed?
• The procedure is carried out in an operating theatre under a short general anaesthesia (while you are asleep), spinal anaesthesia or local anaesthesia
• A telescopic camera will be inserted into your bladder through your urethra to inspect your urethra and bladder
• The bulking agent is then injected into the tissues around the wall of the urethra to raise cushions of tissue which help to keep in closed
• Most patients go home on the day of the procedure
The risks of the procedure include:
• Mild burning on passing urine
• Mild bleeding in urine
• Failure to improve urinary incontinence significantly requiring a further procedure at a later stage
• Slowing of the urinary flow
• Urinary tract infection requiring antibiotic treatment
• Temporary inability to empty bladder requiring catheterisation
• Urinary frequency and urgency, sometimes with incontinence
• Reaction to the bulking agent
• Anaesthetic or cardiovascular problems possibly requiring intensive care (stroke, heart attack, chest infection)
What are the alternatives?
Non-surgical treatment
• Incontinence pads: if symptoms are not causing you bother, you may choose to do nothing and use pads for urine leakage
• Pelvic floor exercises
• Continence pessaries: a small, soft device placed temporarily inside the vagina is used to treat incontinence that occurs only during exercise
• Weight loss and smoking cessation
Other surgical treatments
• Mid-urethral tape surgery
• Autologous sling procedure
• Colposuspension
• Artificial sphincter placement
Your doctor will discuss with you regarding the suitable options.
When to Seek Medical Attention
Please go to the Emergency Department or contact your care team if you experience:
• Fever (≥38°C), chills
• Difficulty urinating or urinary retention
• Worsening bloody urine
• Painful urination
• Abdominal pain