Presented by: Tzach Aviv MD
Institute of Urology, Rabin Medical Center - Beilinson Hospital

Introduction

Stress urinary incontinence (SUI) is a common complaint among women. While the current treatment of choice is a mid-ureteral sling surgery, it still carries a high complication risk of 30%. Bulkamid, Polyacrylamide hydrogel, is a homogeneous non-particle gel designed to treat SUI by improving the urethral coaptation mechanism. We aim to describe the effectiveness and safety of BULKAMID trans-urethral injection for female SUI.

Materials

We conducted a retrospective study on female patients aged 18 and older who underwent BULKAMID trans-urethral injection at our institution between 2018 and 2022. Demographic data, urodynamic characteristics, intraoperative details, and complications were collected and analyzed using statistical methods.

Results

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A total of 27 female patients underwent the procedure. Their median age was 65 (IQR 49-74), with a mean BMI of 25.5±4.0. Of these patients, 44% had previous MUS procedures. All the operations were performed under sedation, with a mean procedure time of 11 minutes (range 8-15) and an injection volume of 1.7±0.5cc in 4 sites. The main complications reported were bleeding (1), urgency (2), injection site pain (1), and dyspnea (1). At one-month follow-up,73% of the patients reported improvement in symptoms, 36.3% showed no leakage in physical examination, and 38.1% reported subjective and objective improvement. Younger age (56 Vs. 74, p=0.01) correlated with subjective improvement. Weight, previous MUS procedure, and injection volume were not significantly correlated with clinical outcomes. Seven (25.9%) patients received additional BULKAMID injection (TOP-UP) as an ancillary procedure, with three patients reporting improvement. Four (14.8%) patients from the entire cohort had undergone other treatments for SUI. 

Conclusion

Urethral BULKAMID injection is a safe and effective treatment for SUI. A larger cohort is needed to characterize this treatment's target population better.

Funding

None

Lead Authors

Amir Buchler, MD
Meir Medical Center Tel-Aviv University

Jack Baniel, MD
Institute of Urology, Rabin Medical Center - Beilinson Hospital

Shachar Aharony, MD
Institute of Urology, Rabin Medical Center - Beilinson Hospital