Urethral Bulking Injection

Who is a candidate for a urethral bulking injection?

A urethral bulking injection is an option for women who have the following conditions:

• Stress urinary incontinence after a urethral sling
• Stress urinary incontinence in women who cannot have surgery due to other medical conditions
• Urinary sphincter dysfunction
• Urethral hypermobility

You are not a candidate for a urethral bulking injection if you have:

• A current urinary tract infection
• Difficulty emptying the bladder
• Have an obstruction in the urethra

If you are undergoing cancer treatments that have impacted the pelvic muscles, a urethral bulking injection may not be an appropriate option either.

Risks of a urethral bulking injection

Complications associated with a urethral bulking injection are rare but may include:

• Worsening of a patient’s stress incontinence (temporary or permanent)
• Bladder infection or urinary tract infection
• Discomfort at the injection site
• Urinary retention - difficulty urinating
• Allergic reactions to anesthesia or bulking agent used during the procedure

What to expect during a urethral bulking injection

A urethral bulking injection is typically performed in a hospital under:

• Local anesthesia, where the bladder and urethra will be numbed
• Regional, where the body below the waist is numbed
• General anesthesia, where you are put to sleep

During the procedure, your doctor will insert a cystoscope into the urethra to see the inside of the urethra. Your doctor will then insert a needle into the sphincter and inject a bulking agent through the needle into the urethra wall. The bulking agent should make the urethra wall thicker, close and stop the flow of urine out of the bladder. When you need to urinate, the wall will allow the urine to flow normally out of the urethra.

Recovery from a urethral bulking injection

You will be able to go home the same day as the procedure after the anesthesia wears off and you can urinate on your own.

If you are not able to urinate on your own, a catheter may be inserted until you can urinate normally. At discharge, you will be given a prescription for antibiotics to prevent infection.

Most patients return to their normal routine within a few days after the procedure. Your doctor will give you detailed instructions on what you can expect during the recovery period.

If you experience any of the following symptoms, please call your doctor right away:

• Bleeding
• Difficulty urinating
• Signs that indicate infection including:
  Fever over 100.4 degrees F
  Frequent urges to urinate
  Chills

Results from urethral bulking injection

Although most patients experience relief from a urethral bulking injection, approximately 30 percent of patients may need a second bulking injection.