Urethral Bulking Agents

What are urethral bulking agents?

Urethral bulking is a good treatment option for some people experiencing stress incontinence. If you have underlying medical conditions that make surgery a greater risk, you may be an ideal candidate for urethral bulking. Individuals who simply prefer to avoid a surgical procedure may also be eligible candidates. Speak to a doctor who would administer a urethral bulking agent to determine your eligibility. Your physician will also outline the recovery period and any long-term care that is needed after the procedure.

When should you explore getting urethral bulking agents?

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A urethral bulking procedure is an option that you can consider if you have any of the following conditions:

  • Stress urinary incontinence after getting a urethral sling
  • Urethral hypermobility
  • Urinary sphincter dysfunction
  • An SUI, but you cannot have surgery for medical reasons

It is advisable that you speak with your physician as soon as possible if you suspect that you have urinary incontinence. An expert will help walk you through the options and determine if there is another one that is better suited for you. You will not be eligible for a urethral bulking procedure if you have:

  • A current urinary tract infection
  • Any difficulty emptying your bladder
  • An obstruction in the urethra

UTIs will only temporarily delay the procedure and require you to reschedule it for a later date.

How do you receive urethral bulking agents?

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Urethral bulking agents are administered by a urogynecologist. The procedure is generally quick and performed in-office under local anesthesia. A specialist will insert a thin camera with a light on the end into the urethra to inspect your bladder and urethra. The bulking material is injected directly into the urethra. The full procedure lasts about five minutes with minimal discomfort. You will be able to drive home independently after the procedure is completed.

What are the side effects of urethral bulking agents?

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All procedures come with some risks, but modern urethral bulking is a safe and straightforward procedure. Some of the immediate side effects to keep an eye out for are:

  • A burning sensation while urinating
  • A small amount of bleeding during urination

These side effects should lessen throughout the day after the procedure. You may also experience longer term side effects, such as:

  • A urinary tract infection
  • Difficulty emptying your bladder
  • Signs that suggest an infection (fever, chills, frequent urges to urinate)

Speak with your urogynecologist if you encounter any of these side effects. The rarer side effects, although perhaps more alarming, are easily treated.

What is the recovery time for urethral bulking agents?

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As a less invasive option, you will be able to return home on the same day as a urethral bulking procedure. You only need to wait until the anesthesia has worn off and you are able to urinate on your own. The doctor may insert a catheter until you are able to urinate without any difficulty. As you are discharged, the doctor will provide you with a prescription for antibiotics to prevent any infection. Your doctor will also outline what you should expect and any instructions to follow during the recovery period. Most patients resume their normal, daily lives after a few days.

How can I treat side effects of urethral bulking agents?

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There are a few over-the-counter and at-home remedies that your doctor may recommend for the post-procedure side effects. These treatment options may include:

  • Over-the-counter medicine to relieve burning
  • A warm bath or damp compress to relieve genital discomfort

Even if your symptoms are minor, it is never a bad idea to speak with an expert. Contacting your physician will provide you with clearer answers and minimize the likelihood of needing long-term treatment.

How effective are urethral bulking agents?

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The effectiveness of urethral bulking agents varies on a person-by-person basis. The average success rate for a woman with stress urinary incontinence is 60-70%. The effects often reduce over time and you may require repeat injections to sustain your relief.

What are the alternatives to urethral bulking agents?

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There are multiple ways that a doctor may recommend you treat stress urinary incontinence before you receive urethral bulking agents. Lifestyle and behavioral adjustments are usually explored, or at least discussed, beforehand based on the severity of your SUI. The behavior adjustments that can help reduce or eliminate incontinence all-together include:

  • Pelvic floor muscle exercises
  • Regulating the types of fluids that you drink and when you drink them
  • Adding fiber to your diet
  • Losing excess weight
  • Quitting smoking
  • Treating an ongoing cough
  • Bladder training

There are surgical and other procedures that your doctor may recommend as possibilities for treatment. Minimally invasive options that may provide greater relief for you than urethral bulking agents are:

  • Midurethral sling procedure
  • Bladder neck sling procedure
  • Retropubic colposuspension

A bladder neck sling procedure and retropubic colposuspension can also be more invasive depending on the size and location of the incision. Male stress incontinence can also be treated by utilizing an inflatable artificial sphincter. The device is inserted surgically and may require a follow-up surgical procedure to keep it fully functioning.

What are coping options if urethral bulking agents are not effective?

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Urine leakage may still happen every now and then after you receive urethral bulking agents. Staying prepared in the event of any leaks will help to improve your social, professional, and emotional experiences. When you go out with friends and family, it may be helpful to:

  • Know where you are going and the restroom accessibility
  • Stock up on necessary supplies
  • Take care of your skin (changing into dry clothes, using barrier cream)

Stress urinary incontinence can also have an effect on interpersonal and sexual relationships. Possible ways to avoid or simply better navigate incontinence during sex are:

  • Talking with your partner
  • Emptying your bladder beforehand
  • Trying a different position
  • Doing Kegel exercises to strengthen pelvic floor muscles
  • Keeping towels or disposable pads nearby

Incontinence does not need to control your life. Urethral bulking agents are one way to take back control and regain your confidence. Speaking with a physician to learn more about the options that are right for you is the first step.

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