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Periurethral Bulking Injection for Incontinence

Minimally invasive office-based treatment for stress urinary incontinence.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Üroloji department. Book Appointment →

What is Periurethral Bulking Injection for Incontinence?

Periurethral bulking injection is a minimally invasive office-based procedure for stress urinary incontinence (SUI), particularly intrinsic sphincter deficiency (ISD). A bulking agent is injected into the submucosa around the urethra to coapt the lumen, increasing outlet resistance during coughing or stress maneuvers.

Modern bulking agents include polyacrylamide hydrogel (Bulkamid), polydimethylsiloxane (Macroplastique) and calcium hydroxylapatite (Coaptite). The procedure is performed under local anesthesia with cystoscopic guidance and is particularly suited for patients with hypermobility-free SUI, those unfit for sling surgery, or as a temporary or repeat treatment.

Symptoms

Urine leakage with cough, sneeze, laugh or exercise
Decreased urethral mobility on Q-tip test
Low Valsalva leak point pressure (under 60 cm H2O) suggesting ISD
Failed pelvic floor muscle therapy
Pad usage during physical activity
Mixed incontinence with predominant stress component
Frail elderly patient unfit for sling surgery

Risk Factors

Vaginal childbirth and obstetric trauma
Pelvic surgery (hysterectomy, prolapse repair)
Pelvic radiation therapy
Postmenopausal estrogen deficiency
Chronic cough and obesity
Connective tissue disorders
Aging and decreased urethral collagen

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent stress urinary incontinence
  • Failure of conservative therapy after 3-6 months
  • Recurrent SUI after prior anti-incontinence surgery
  • Mild to moderate SUI with patient preference for office procedure
  • Contraindication to sling surgery (bleeding risk, anesthesia risk)
  • Worsening pad use and quality of life

Treatment Methods

01
Urodynamic evaluation to confirm SUI and ISD
02
Cystoscopic assessment of urethra and bladder
03
Patient counseling on success rates and need for repeat injections
04
Outpatient procedure under local anesthesia
05
Cystoscopic injection of bulking agent at multiple urethral sites
06
Avoidance of strenuous activity for 24-48 hours
07
Voiding trial before discharge
08
Follow-up at 6-12 weeks for symptom and pad weight assessment
09
Repeat injection or alternative therapy if inadequate response

Which Department to Visit?

You can visit our Üroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.