Surgery Overview
Urethral bulking to treat
urinary incontinence involves injecting material
(such as collagen) around the
urethra. This may be done to:
- Close a hole in the urethra through which urine leaks out.
- Build up the thickness of the wall of the urethra so it seals
tightly when you hold back urine.
Most bulking materials are injected around the urethra just
outside the muscle of the urethra at the bladder outlet. Injecting the bulking material may be done through the skin,
through the urethra or, in women, through the vagina. Needle placement is
guided by the use of a
cystoscope inserted into the urethra.
Urethral bulking procedures are usually done under
local anesthesia in women, but men may require a
general or
regional anesthesia. A local anesthetic allows the
person to stand up after an injection to find out if continence has been
achieved. If continence has not been restored, another injection may be done
immediately.
This treatment may help, but the effect wears off over time. It is common to need more treatments.
The surgery is used mostly for women and sometimes
for men.
What To Expect After Surgery
Most urethral bulking injections can
be done in a doctor's office or surgery center. They rarely require
a hospital stay. You may need to take it easy for a few days afterward.
Why It Is Done
Urethral bulking may be done to
treat:
- Mild
stress incontinence in women.
- Stress incontinence in women who don't want or can't have surgery.
- Mixed (stress and urge) incontinence.
- Mild stress incontinence in men that results from prostate
surgery.
How Well It Works
Urethral bulking may work for some women. But fewer than 4 out of 10 women have long-term benefits.footnote 1
Risks
The main risks related to urethral bulking are
pain at the injection site, injury to the urethra, and migration of the bulking
material.
What To Think About
This surgery is used mostly for
women and sometimes for men.
This treatment method
avoids the risks associated with abdominal surgery.
Before having
urethral bulking treatment, ask your doctor about the following:
- How much success has the doctor had in treating incontinence with surgery? The success of surgical procedures for
urinary incontinence depends on the experience and skill of the surgeon.
- Is there anything I can do to increase the likelihood of a successful surgery? Losing weight, quitting smoking, or
doing pelvic floor (Kegel) exercises before surgery may increase the likelihood
of regaining continence after surgery.
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
References
Citations
- American Urological Association (2009). Guideline for the surgical management of female stress urinary incontinence: Update (2009). Available online: http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines.cfm.
Credits
ByHealthwise Staff
Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine
Adam Husney, MD - Family Medicine
Specialist Medical ReviewerAvery L. Seifert, MD - Urology