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Conditions & Treatments

Urethral Bulking Injection

What is it?

A urethral bulking injection is an office-based treatment to stop the urinary leakage that occurs with cough, sneeze, laughter and exercise. The injection helps to create a tighter seal at the top of the urethra to prevent urine from leaking out. It is a great option for women who wish to treat their stress urinary incontinence with an effective, long-lasting, office-based procedure. It is also an especially nice option for women who wish to avoid the risks of undergoing surgery or those who cannot undergo a few weeks of postoperative recovery which precludes vigorous activity or heavy lifting.

At Women’s Urology New York, we use Bulkamid hydrogel for our urethral bulking injections. Bulkamid is a water-based gel which has been used safely in over 70,000 female patients, and can be offered as first line treatment for stress urinary incontinence.

To determine whether you are a good candidate for this procedure, you should schedule an appointment with Dr. Kumar for a consultation and physical exam.

How is the injection done?

In the office, you will receive an anesthetic gel as well as injection to numb the nerves inside and around the urethra. A cystoscope (which looks like a short tube with a camera at the end) is then gently placed into the urethra. This is done to visualize the opening of the urethra close to the bladder neck. A small needle is then inserted in 3-4 areas of the urethra, and a soft gel is injected underneath the mucosa to plump up the tissue and augment the closure mechanism. You will feel a pinching or a slight burning sensation when the needle is inserted.

After the procedure, we will make sure you are able to urinate before you go home.

How effective is the procedure?

In a large study of women who had the Bulkamid injection, about 80% experienced significant clinical improvement in their leakage, and almost 50% reported zero incontinence episodes afterward. Due to excellent efficacy of the bulking injection, the minimally invasive nature, and the lack of serious adverse events associated with this procedure, the patient satisfaction rate is high. In a study which compared patient satisfaction with Bulkamid versus the sling surgery, 92% of women reported being very satisfied with the Bulkamid procedure.

To learn more about Bulkamid, click here.

What should I expect afterward?

You should notice an improvement in your urinary leakage immediately after the procedure, and that you no longer require as many, or any pads at all. Occasionally, the bulking effect can make it more difficult for you to empty your bladder and you may notice your urinary stream is weaker or you are not able to empty your bladder completely. This typically resolves in 1-2 days.

References and Trusted Resources

  1. Soisalo P, Tulokas S, Mikkola TS. Tension-Free Vaginal Tape Surgery versus Polyacrylamide Hydrogel Injection for Primary Stress Urinary Incontinence: A Randomized Clinical Trial. J Urol. 2020 Feb;203(2):372-378. PMID: 31479396.
  2. Pushkar DY, Kasyan GR. Re: TVT Surgery versus Bulkamid Injection for Primary Stress Urinary Incontinence: A Randomized Clinical Trial. Eur Urol. 2020 Apr;77(4):561-562. PMID: 31836250.

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