Urethral bulking injections are used to treat women with stress incontinence who would prefer to avoid more invasive traditional surgery.

The procedure involves injecting a permanent though biologically inactive substance underneath the urethral lining through a small camera placed in the urethra. The bulking effect creates physical compression and partial closure of the urethra to limit urine leakage.

When to ask a Urologist about Urethral Bulking Injections

You should speak with a Urologist about Urethral Bulking Injections if you are bothered by stress urinary incontinence and prefer a minimally-invasive procedure over the traditional surgical approach.

Cost

Typically covered by most insurances (although coinsurance and deductibles may apply). Coverage will be verified prior to proceeding. If you do not have insurance, our office will be able to give you an out-of-pocket cost estimate.

Effectiveness

Following urethral bulking injections, about half of patients report improvement and about 20% of patients are dry. Urethral bulking injections have reduced efficacy and duration compared to surgical procedures such as urethral slings.

Possible Side Effects

The risks of urethral bulking injections include pain, bleeding, infection, damage to surrounding structures, difficulty urinating, need for catheterization, urinary urgency or irritation, recurrent or persistent urine leakage, and migration of the injectable material to other locations.

Alternative Approaches

Alternatives to urethral bulking injections may include observation without treatment, chronic catheterization, or urethral sling placement.

What to do to Prepare for Surgery

You will receive detailed instructions from the surgical schedulers regarding any necessary testing or appointments prior to surgery. In general, you should temporarily stop blood-thinning medications prior to surgery (when to stop depends on the type of blood thinner). Prescription blood-thinning medications should be stopped following clearance from the doctors that prescribed them though other medications that thin the blood including fish oil and pain relievers such as ibuprofen should be stopped as well.

On the day before surgery, you will receive a phone call alerting you to the time that you should arrive.

You should not eat or drink anything after midnight on the day of surgery, but you may take approved home medications in the morning before surgery with a small sip of water.

What to Expect after Surgery

The procedure is performed in an outpatient setting under light sedation with patients returning home following its completion. It is common to have minor blood in the urine and to experience irritation with urination following the procedure. Most patients experience improvement in their incontinence shortly after the procedure.

Post-Operative Instructions

Surgical Site

• There are no incisions or dressings.
• There may be slight tenderness, burning and swelling at the opening of the urethra.

Diet and Activity

• You may return to your normal diet and light activity, as tolerated, after surgery but avoid driving while on narcotic pain medications.
• Please avoid any heavy lifting more than 10 lbs or strenuous physical activities altogether for several days and then ease back into your regular activity.
• Staying well hydrated is recommended to help dilute the urine and flush away any potential debris or residual bleeding.

Medications

• Over-the-counter medications such as extra strength Tylenol (acetaminophen) or nonsteroidal anti-inflammatory drugs (ibuprofen, Motrin, Advil, Aleve) can be used if needed for pain as directed.
• Please avoid nonsteroidal anti-inflammatory drugs or any other blood thinners if your urine is bloody until the bleeding has cleared.

Problems you should report

• Fevers > 101.
• Any pain not controlled by oral medication.
• Persistent burning with urination.
• Inability to urinate.
• Thick blood in the urine (similar to dark fruit punch or tomato juice).
• Any concerns or problems, please contact us at (717) 393-1771 anytime.

Follow-up

You should be scheduled for a post-operative appointment about 2-4 weeks after surgery. Please call (717) 393-1771 to confirm time and location.