Urethral Bulking

Stress incontinence is the leakage of urine with everyday activities including walking, coughing, sneezing, lifting or exercise. The severity of stress incontinence varies between person to person. Stress incontinence is caused by weakening of the muscles and ligaments that normally support the urethra and allow it to close firmly when straining or exercising to prevent urine leakage.

Stress incontinence may improve or resolve with conservative management such as pelvic floor exercises and lifestyle changes. If conservative management has failed, or previous sling surgery has been inadequate, then you may be recommended for treatment using a bulking agent. A bulking agent can be used to improve the closing mechanism of the urethra.

Incontinence: The urine passes unhindered from bladder to urethra.

The bulking agent injected into the sub-mucosal tissue of the urethral wall.

The bulking effect prevents urine to pass by supporting the closing mechanism.

This procedure requires a day admission and is performed under a combination of local anaesthesia and sedation. Occasionally an overnight admission is required. It involves injecting the bulking agent to the urethra via a cystoscopy. The goal of treatment is to bring about an effective seal of the inner lining of the urethra thus preventing any urinary leakage. A second dose of the bulking agent is sometimes used some weeks / months later as a top-up treatment if required.

Before surgery

  • Ensure your hospital paperwork is completed and sent to the hospital at least 7 days before surgery.
  • Ensure you have urine test 1 week before your procedure. If an infection is detected, you will need antibiotics before surgery can proceed.
  • If you are a Diabetic, are on any blood thinning medications or have any allergies please contact the Practice nurse at your earliest convenience.
  • You will be instructed on how to catheterize intermittently using a disposable catheter. Education and sample catheters will be provided to you before surgery. This is necessary if you have any difficulties passing urine following surgery.

Following surgery

  • You will be transferred to the ward where nursing staff will monitor how effectively you are able to empty your bladder. If you have any difficulties, then you may be instructed to use an intermittent catheter.
  • You will be able to eat and drink as normal.
  • You will be discharged once it is confirmed you are emptying your bladder adequately

Following discharge

  • You will return to the rooms for an ultrasound residual one week following surgery. Please empty your bladder when you arrive to the rooms and the nurse will then perform an ultrasound residual using the bladder scanner.
  • You will also see your surgeon who will check on your progress.
  • You will need to return to the rooms for your first post-operative appointment 6 weeks after surgery. At this appointment you will also require another ultrasound residual. Please empty your bladder when you arrive to the rooms and the nurse will then perform an ultrasound residual using the bladder scanner.
  • You are able to return to all activities including driving following your surgery.

You are advised to call the rooms if you develop any of the following symptoms:

  • Difficulty or inability to pass urine
  • Fever/chills
  • Offensive urine,
  • Frequency, urgency and burning when trying to pass urine
  • Blood in urine