Urethral bulking agent injections are used to treat stress urinary incontinence (SUI), a condition where involuntary urine leakage occurs. SUI can happen during physical activities such as laughing, sneezing, exertion, coughing, lifting, or sexual activity, which increase intra-abdominal pressure.
Risk Factors for SUI
The likelihood of developing SUI is higher for older individuals, Caucasians, smokers, those who are obese, and those diagnosed with lung disease. Additional risk factors include being female, pregnancy, childbirth, chronic coughing, lower back nerve injuries, and pelvic or prostate surgery.
In women, SUI is linked to intrinsic sphincter deficiency (ISD) and urethral hypermobility, which is when the urethra loses its anatomical support.
Diagnosing SUI
To diagnose stress urinary incontinence (SUI), the physician will assess the triggers of incontinence, the level of subjective distress, frequency of episodes, quantity of leakage, and the patient’s treatment goals and expectations.
During the physical examination, the physician will check for pelvic organ prolapse, urethral hypermobility, and vaginal atrophy. A standing stress test will also be conducted to observe leakage. A urinalysis can screen for urinary tract infection and hematuria, and a post-void residual test may be performed to rule out urinary retention.
Men with SUI symptoms will have their abdomen, prostate, rectum, and genitalia examined. During an examination, they may be asked to squeeze their pelvic and sphincter muscles during a Kegel test. The physician might also ask the patient to perform actions like straining, stepping, and coughing to see if these cause urine leakage.
Additional diagnostic tools may include keeping a voiding diary, pad testing, urodynamics, and cystoscopy. A voiding diary tracks fluid intake, daily symptoms, and urination frequency, noting when leaks occur and what the patient was doing at the time.
A pad test, conducted over one hour or 24 hours, measures leakage during exercise or movement. The pad is weighed afterward to determine the amount of urine leaked.
Treating SUI with Urethral Bulking Agent Injections
Urethral bulking agent injections are used to strengthen the urethral sphincter muscle, helping it to effectively close the bladder. These agents are injected into the urethra to enhance sphincter function. The FDA-approved agents currently offered by the UCI Pelvic Health Center are:
- Silicon microparticles (Macroplastique®)
- Polyacrylamide hydrogel (Bulkamid®)
Injections are usually administered under local anesthesia in a physician’s office and may be repeated if necessary. Although not as effective as other surgeries, the recovery time is short. Urethral bulking agents provide temporary relief for SUI, with one in three women experiencing up to one year of incontinence relief.
Risks of Urethral Bulking Agent Injections
Potential risks include transient difficulty voiding, transient hematuria, temporary urinary retention, urinary tract infection, temporary irritative voiding symptoms, and elevated post-void residual urine. Rarely, material erosion can occur.
Patients should consult their physician to determine if urethral bulking agent injections are a suitable treatment option for them.
Choose UCI Pelvic Health Center
Experience relief from stress urinary incontinence with Urethral Bulking Agent Injections at UCI Pelvic Health Center. Using FDA-approved agents like Macroplastique® or Bulkamid®, our minimally invasive treatments can help restore your confidence and quality of life.