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Urethral Bulking for Urinary Incontinence

Surgery Overview

Urethral bulking to treat urinary incontinence involves injecting material (such as collagen) around the urethra. This may be done to build up the thickness of the wall of the urethra so it seals tightly when you hold back urine.

Most bulking materials are injected around the urethra just outside the muscle of the urethra at the bladder outlet. Injecting the bulking material may be done through the urethra or, in women, through the vagina. Needle placement is guided by the use of a cystoscope inserted into the urethra.

Urethral bulking procedures are usually done under local anesthesia or with sedation. But they may require a general or regional anesthesia. Using local anesthesia or sedation allows the person to stand up after an injection to find out if continence has been achieved. If continence has not been restored, another injection may be done.

This treatment may help, but the effect may wear off over time. It is common to need more treatments.

The surgery is used mostly for women and sometimes for men.

What To Expect

Most urethral bulking injections can be done in a doctor's office or surgery centre. You may need to take it easy for a few days afterward and will need to avoid heavy lifting and strenuous activities for 4 to 6 weeks.

Why It Is Done

Urethral bulking may be done to treat:

  • Stress incontinence in women. There are different types of surgery used to treat stress incontinence. Talk to your doctor about what is best for you.
  • Mild stress incontinence in men that results from prostate surgery.

How Well It Works

Urethral bulking may work for some women. But fewer than 4 out of 10 women have long-term benefits.footnote 1

Risks

There are some risks related to urethral bulking. For example, you may have trouble urinating after the procedure. This often goes away after a few days. Some other risks include pain at the injection site, injury to the urethra, and migration of the bulking material.

References

Citations

  1. American Urological Association (2009). Guideline for the surgical management of female stress urinary incontinence: Update (2009). Available online: http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines.cfm.

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