Overview
Urethral bulking involves injecting a biocompatible material around the urethra to improve its ability to close and reduce urine leakage during activities such as coughing, sneezing, or exercise.
Best Suited For
- Women with mild stress urinary incontinence
- Patients who are not ideal surgical candidates
- Women who prefer a less invasive option
- As a bridge or alternative when sling surgery is not desired
The Procedure
- Performed as an outpatient procedure under local anesthesia
- A cystoscope is used to guide injection of the bulking agent around the urethra
- The procedure takes approximately 15-30 minutes
- You can usually go home the same day
Effectiveness
- Success rates are lower compared to midurethral sling surgery
- Approximately 50-70% of women experience improvement
- The effect may diminish over time, and repeat injections are often needed (typically every 12-18 months)
Advantages
- Minimally invasive with no incisions
- Short procedure time
- Can be performed under local anesthesia
- Low risk of complications
Limitations
- Less durable than sling surgery
- Often requires repeat treatments
- Not suitable for moderate to severe stress incontinence
Risks and Success Rates
Urethral bulking injections achieve cure or improvement in 60-70% of women with stress urinary incontinence. The effect tends to diminish over time, and over one-third of women require a repeat injection. Potential risks include:
- Pain on urination — burning or stinging that typically resolves within 24-48 hours
- Temporary voiding difficulty — less than 10% of patients may temporarily require a catheter
- Blood in the urine — may occur briefly after the procedure
- Urinary tract infection
- Migration of bulking material from the injection site — rare
- Granuloma formation — a localized tissue reaction at the injection site — rare
- Allergic reaction — rare
Illustrations courtesy of the International Urogynecological Association (IUGA) Patient Information Leaflets.