Skip to main content

Advertisement

SpringerLink
Log in

Outpatient periurethral injections of polyacrylamide hydrogel for the treatment of female stress urinary incontinence: effectiveness and safety

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To investigate the effectiveness and safety of periurethral injections (PIs) of polyacrylamide hydrogel (PAHG, Bulkamid®) for the treatment of female stress urinary incontinence (SUI).

Methods

This double-centre prospective study included 82 female patients with SUI who were treated with PIs of PAHG between January 2008 and December 2010 in outpatient setting. The International Consultation on Incontinence Questionnaire short form (ICIQ-SF) and the Patient Global Improvement Impression (PGI-I) were used to assess incontinence and patient satisfaction after treatment. The impact of incontinence on quality of life (QoL) was investigated using the Incontinence Impact Questionnaire (IIQ-7).

Results

All patients were discharged on the same day of treatment and there was no intraoperative complication. At 1-year follow-up, the efficacy of PIs of PAHG (subjective success rate) was 74.4 %. The subjective responder rate was 86.6 %, 8.5 % of patients had no change and no patient reported worsening of symptoms. The mean number of episodes of urine leakage/24 h and the mean leakage/24 h significantly decreased after treatment. At 1-year follow-up, the IIQ-7 results were significantly improved compared with baseline. 25.6 % of patients had adverse events (mainly urinary tract infections and injection site pain).

Conclusion

This study demonstrates that PIs of PAHG are effective and safe and cause significant improvement of the QoL at 1-year follow-up. PIs of PAHG can be safely performed in an ambulatory setting and patients may be discharged on the day of the procedure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Meyer L (1904) 2 tilfælde af incontinentia urinae helbredede ved Parafininjektioner. Ugeskr Laeger 104:5

    Google Scholar 

  2. Smith ARB, Daneshgari F, Dmochowski R et al (2005) Surgery for urinary incontinence in women. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence, Chap 20. Health Publication Ltd, Paris, pp 1297–1370

    Google Scholar 

  3. Klarskov N, Lose G (2008) Urethral injection therapy: what is the mechanism of action? Neurourol Urodyn 27:789–792

    Article  PubMed  Google Scholar 

  4. Kirchin V, Page T, Keegan PE et al (2012) Urethral injection therapy for urinary incontinence in women. Cochrane Database Syst Rev 15(2):CD003881

    Google Scholar 

  5. Bump RC, Mattiasson A, Bø K et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17

    Article  PubMed  CAS  Google Scholar 

  6. Crystle CD, Charme LS, Copland WE (1971) Q-tip test in stress urinary incontinence. Obstet Gynecol 38:313–315

    PubMed  CAS  Google Scholar 

  7. Avery K, Donovan J, Peters TJ et al (2004) ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourol Urodyn 23:322–330

    Article  PubMed  Google Scholar 

  8. Uebersax JS, Wyman JF, Shumaker SA et al (1995) Short forms to assess life quality and symptom distress for urinary incontinence in women: the incontinence impact questionnaire and the urogenital distress inventory. Continence program for women research group. Neurourol Urodyn 14:131–139

    Article  PubMed  CAS  Google Scholar 

  9. Yalcin I, Bump RC (2003) Validation of two global impression questionnaires for incontinence. Am J Obstet Gynecol 189:98–101

    Article  PubMed  Google Scholar 

  10. Thüroff JW, Abrams P, Andersson KE et al (2010) EAU guidelines on urinary incontinence. Eur Urol 59:387–400 (Epub 2010 Nov 24)

    Article  PubMed  Google Scholar 

  11. Serati M, Salvatore S, Uccella S et al (2009) Surgical treatment for female stress urinary incontinence: what is the gold-standard procedure? Int Urogynecol J Pelvic Floor Dysfunct 20:619–621

    Article  PubMed  Google Scholar 

  12. Lee PE, Kung RC, Drutz HP (2001) Periurethral autologous fat injection as treatment for female stress urinary incontinence: a randomized double-blind controlled trial. J Urol 165:153–158

    Article  PubMed  CAS  Google Scholar 

  13. Chapple CR, Brubaker L, Haab F et al (2007) Patient-perceived outcomes in the treatment of stress urinary incontinence: focus on urethral injection therapy. Int Urogynecol J Pelvic Floor Dysfunct 18:199–205 (Epub 2006 Jul 18)

    PubMed  Google Scholar 

  14. Lose G, Mouritsen L, Nielsen JB (2006) A new bulking agent (polyacrylamide hydrogel) for treating stress urinary incontinence in women. BJU Int 98:100–104

    Article  PubMed  CAS  Google Scholar 

  15. Lose G, Sørensen HC, Axelsen SM et al (2010) An open multicenter study of polyacrylamide hydrogel (Bulkamid®) for female stress and mixed urinary incontinence. Int Urogynecol J 21:1471–1477 (Epub 2010 Jul 20)

    Article  PubMed  Google Scholar 

  16. Toozs-Hobson P, Al-Singary W, Fynes M et al (2012) Two-year follow-up of an open-label multicenter study of polyacrylamide hydrogel (Bulkamid®) for female stress and stress-predominant mixed incontinence. Int Urogynecol J 23:1373–1378 (Epub 2012 Apr 25)

    Article  PubMed  Google Scholar 

  17. Mohr S, Siegenthaler M, Mueller MD et al (2012) Bulking agents: an analysis of 500 cases and review of the literature. Int Urogynecol J (Epub ahead of print)

  18. Trutnovsky G, Tamussino K, Greimel E et al (2011) Quality of life after periurethral injection with polyacrylamide hydrogel for stress urinary incontinence. Int Urogynecol J 22:353–356 (Epub 2010 Oct 9)

    Article  PubMed  Google Scholar 

  19. Leone Roberti Maggiore U, Alessandri F, Medica M, et al (2012) Periurethral injection of polyacrylamide hydrogel for the treatment of stress urinary incontinence: the impact on female sexual function. J Sex Med 9:3255–3263. doi:10.1111/j.1743-6109.2012.02955.x

  20. Gil KM, Somerville AM, Cichowski S et al (2009) Distress and quality of life characteristics associated with seeking surgical treatment for stress urinary incontinence. Health Qual Life Outcomes 5:7–8

    Google Scholar 

  21. Robinson D, Anders K, Cardozo L et al (2003) What do women want? Interpretation of the concept of cure. J Pelvic Med Surg 9:273–277

    Article  Google Scholar 

  22. Hullfish KL, Bovbjerg VE, Gibson J et al (2002) Patient-centered goals for pelvic floor dysfunction surgery: what is success, and is it achieved? Am J Obstet Gynecol 187:88–92

    Article  PubMed  Google Scholar 

  23. Hullfish KL, Bovbjerg VE, Steers WD (2004) Patient-centered goals for pelvic floor dysfunction surgery: long-term follow-up. Am J Obstet Gynecol 191:201–205

    Article  PubMed  Google Scholar 

  24. Elkadry EA, Kenton KS, FitzGerald MP et al (2003) Patient-selected goals: a new perspective on surgical outcome. Am J Obstet Gynecol 189:1551–1557 (discussion 1557–1558)

    Article  PubMed  Google Scholar 

  25. Mahajan ST, Elkadry EA, Kenton KS et al (2006) Patient-centered surgical outcomes: the impact of goal achievement and urge incontinence on patient satisfaction one year after surgery. Am J Obstet Gynecol 194:722–728

    Article  PubMed  Google Scholar 

  26. Chapple CR, Wein AJ, Brubaker L et al (2005) Stress incontinence injection therapy: what is best for our patients? Eur Urol 48:552–565

    Article  PubMed  Google Scholar 

  27. Plotti F, Zullo MA, Sansone M et al (2009) Post radical hysterectomy urinary incontinence: a prospective study of transurethral bulking agents injection. Gynecol Oncol 112:90–94 (Epub 2008 Oct 25)

    Article  PubMed  Google Scholar 

  28. Kotb AF, Campeau L, Corcos J (2009) Urethral bulking agents: techniques and outcomes. Curr Urol Rep 10:396–400

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

We have no potential conflict of interest to disclose.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, San Martino Hospital and National Institute for Cancer Research, University of Genoa, Largo Rosanna Benzi 1, 16132, Genoa, Italy

    Umberto Leone Roberti Maggiore, Franco Alessandri, Pier Luigi Venturini & Simone Ferrero

  2. Departement of Urology, Sestri Levante Hospital, 16039, Sestri Levante (Genoa), Italy

    Mauro Medica & Maurizio Gabelli

Authors
  1. Umberto Leone Roberti Maggiore
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Franco Alessandri
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mauro Medica
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Maurizio Gabelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Pier Luigi Venturini
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Simone Ferrero
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Umberto Leone Roberti Maggiore.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Leone Roberti Maggiore, U., Alessandri, F., Medica, M. et al. Outpatient periurethral injections of polyacrylamide hydrogel for the treatment of female stress urinary incontinence: effectiveness and safety. Arch Gynecol Obstet 288, 131–137 (2013). https://doi.org/10.1007/s00404-013-2718-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-013-2718-y

Keywords

Search

Navigation