Urethral bulking agents
Urethral bulking agents are one surgical option for treating incontinence. In this surgery, a water-based gel is injected into the walls of the urethra. The urethra is the tube that carries wee (urine) from the bladder to outside the body.
About urethral bulking agents
The bulking agent helps the urethra make a watertight seal and prevent wee leaking from the bladder.
Bulking agents are permanent materials that do not dissolve.
This surgical option is often referred to by the product (trade) name, such as Bulkamid or Macroplastique. Macroplastique contains silicone.
Source: British Association of Urological Surgeons (BAUS)
Main advantages of urethral bulking agents
- This surgical option involves day surgery, and recovery is quick (24 to 48 hours).
- It is less invasive because there are no skin cuts.
- People having this surgery have fewer issues with emptying their bladder, compared to other surgeries.
- This surgery has no impact on the success of any future surgery.
- The bulking agent can also be injected at the same time as surgery for other problems, for example, prolapse.
Main disadvantages of urethral bulking agents
- This surgical option has lower success at reducing incontinence compared with other surgical options.
- Repeated injections may be needed, and there is no reliable evidence on long-term success.
- The bulking agent may need to be removed (removal is currently not possible in Aotearoa New Zealand).
- Bulking agents are not natural products (foreign body), which means your body may respond to having them inside you.
Possible risks and complications of urethral bulking agents
There is limited information available about long-term complications. However, the risks are less likely to be serious than with the other surgical options.
Possible risks include:
- your incontinence returning
- your flow of wee slowing down
- getting a burning sensation or bleeding when passing wee for a short period after the bulking agent has been injected.
Other complications include:
- formation of a stone if the bulking agent is exposed into the urethra or bladder
- formation of an abscess where the bulking agent was injected due to infection
- hardening of the bulking material (Macroplastique only)
- pain lasting more than 6 months from scar tissue around the injection site.
Length of stay and time off work
You would go home the same day as the surgery.
You will not require further time off work after the surgery.