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Date issued: August 2022

Review date: August 2024

Ref: B-406/Gynae/KW/Bulkamid Urethral Injections v3

PDF:  Bulkamid Urethral injections final August 2022 v3.pdf [pdf] 167KB

Introduction

Bulkamid injections are a treatment for stress urinary incontinence in women. Bulkamid is a polymer gel and the body easily accepts these substances, and no allergic reactions have been noted. Unlike some other bulking agents this is permanent. Enzymes within the body do not break it down and it is not reabsorbed by the body. It is soft and does not induce scarring around it and no allergic reactions have been seen. It has been used in plastic surgery and to make contact lenses for over 10 years. It acts to bulk out the urethra and make it more difficult for urine to pass.

50-60% of women undergoing urethral bulking will notice cure or improvement of their symptoms. However, the effect tends to reduce over time, and over a third of women request a second injection. The most common complication is a short term difficulty in passing water and affects approximately 2% of patients treated.

Technique

The procedure can be performed under a local or a general anaesthetic. 3-4 injections of Bulkamid™ are placed along the urethral wall (see illustration). You may feel a sharp scratch at this point. Once in place, Bulkamid™ causes better closure, helping in the prevention of urine leakage.

Preparation

If you suffer from frequent water infections, to prevent cancellation on the day, please see your GP for a prescription of prophylactic antibiotics (antibiotics you take in advance to stop an infection) for the 3 days before your surgery date.

The surgeon will confirm the procedure to you and consent you for this procedure. A quick test of urine will be performed to make sure that you do not have any urinary infection prior to the procedure.

You will be asked to change and lie on a special couch. A local anaesthetic will be injected using a small needle and a gel will also be placed in the urethra. The surgical care practitioner will make ready the injections. It is likely that you will feel a small scratch as each injection is placed. The whole procedure takes 15-20 minutes if done under local anaesthetic.

You may return to work the following day, you do not need to starve for the procedure, and you should take your medications as normal.

If you choose to have the procedure under a general anaesthetic, you will be told when and for how long you need to starve, you should expect to be in the hospital for half a day.

Discomfort and aftereffects

You will feel a small amount of discomfort initially, but this will soon cease. Your surgical care practitioner will ensure that you pass urine before leaving.

You will be given an antibiotic tablet to take. During the first 10 days do not use tampons and avoid sexual intercourse.

Risks and complications

Rare complications include:

• Urinary Infections.

• Difficulty emptying the bladder initially (may require a catheter for a short period, very rare).

• Small amount of bleeding.

If not successful, you may be offered a second course of treatment, or may wish to consider one of the alternatives

If you have any further questions or require advice please contact K White or M Cashmore on 01752 433097