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Volume of Bulking Agent Injection: Is It the More ...
Volume of Bulking Agent Injection: Is It the More the Better? - Mickey Buckingham, MD
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This study aimed to evaluate the long-term efficacy of periurethral injection of polyacrylamide hydrogel (PAHG) for stress urinary incontinence in women and determine if there is a correlation between the volume of PAHG injected and the outcome. The study included 115 PAHG injections in 101 patients between 2011 and 2018.<br /><br />The volume of PAHG injected ranged from 0.8mls to 3mls. Two patients reported procedure-related complications, including urinary tract infection and urinary retention requiring intermittent self-catheterization.<br /><br />Of the patients who attended the three-month follow-up, 58.5% reported an improvement in their symptoms, 38.7% reported no change, and 2.8% reported worsening symptoms. Nine patients underwent further definitive incontinence surgery, with mid-urethral tape being the most common choice.<br /><br />The median length of follow-up was 37.5 months. An improvement in International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form score was observed in 45.8% of the patients, with a mean improvement of 4 points. However, there was no significant correlation between the volume of PAHG injected and the change in score after adjusting for age, BMI, and length of follow-up.<br /><br />The study concluded that PAHG injection significantly improved symptoms of urinary incontinence up to 7.5 years after the procedure, with no reported long-term complications. The actual volume of PAHG injected did not impact the outcome for women.<br /><br />References<br /><br />1. Lose G, Mouritsen L, Nielsen JB. A new bulking agent (polyacrylamide hydrogel) for treating stress urinary incontinence in women. BJU Int. 2006;98(1):100-4.<br />2. Kasi AD, Pergialiotis V, Perrea DN, Khunda A, Doumouchtsis SK. Polyacrylamide hydrogel (Bulkamid®) for stress urinary incontinence in women: a systematic review of the literature. Int Urogynecol J. 2016;27(3):367-75.<br />3. Contura. Bulkamid standard operating procedure. 2018.
Keywords
long-term efficacy
periurethral injection
polyacrylamide hydrogel
PAHG
stress urinary incontinence
correlation
volume of PAHG
complications
follow-up
incontinence surgery
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