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Periurethral abscess following polyacrylamide hydrogel (Bulkamid®) for stress urinary incontinence

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Abstract

Bulkamid® is a periurethral bulking agent used to treat stress urinary incontinence (SUI). Manufacturers describe it as nontoxic, nonbiodegradable and biocompatible. Periurethral abscesses are one of the known complications of bulking agents. We present the first reported case of periurethral abscess following Bulkamid® injection. The woman had previously had a transobturator tape (TOT) and total vaginal mesh repair. At 6 weeks after injection of the bulking agent, she reported 100 % cure of her SUI. Transperineal ultrasound was used to diagnose and monitor an abscess that developed anterior and lateral to the urethra and separate from the TOT. Magnetic resonance imaging was helpful in delineating the extent of the abscess into the retropubic space but was not able to identify the urethra or the TOT. Surgical drainage of the abscess was performed vaginally, resulting in successful resolution of pain but recurrence of incontinence.

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Abbreviations

SUI:

Stress urinary incontinence

TOT:

Transobturator tape

UVJ:

Urethrovesical junction

References

  1. Lightner DJ (2002) Review of the available urethral bulking agents. Curr Opin Urol 12(4):333–8

    Article  PubMed  Google Scholar 

  2. Christensen L, Breiting V, Janssen M, Vuust J, Hogdall E (2005) Adverse reactions to injectable soft tissue permanent fillers. Aesth Plast Surg 29(1):34–48

    Article  Google Scholar 

  3. Abdelwahab H, Ghoniem G (2007) Obstructive suburethral mass after transurethral injection of dextranomer/hyaluronic acid copolymer. Int Urogynecol J 18(11):1379–1380

    Article  Google Scholar 

  4. McLennan MT, Bent AE (1998) Suburethral abscess: a complication of periurethral collagen injection therapy. Obstet Gynecol 92(4):650–652

    Article  PubMed  CAS  Google Scholar 

  5. Lightner DJ, Fox J, Klingele C (2010) Cystoscopic injections of dextranomer hyaluronic acid into proximal urethra for urethral incompetence: efficacy and adverse outcomes. Urol 75(6):1310–4

    Article  PubMed  Google Scholar 

  6. Schuettoff S et al (2006) Visibility of the polypropylene tape after tension-free vaginal tape (TVT) procedure in women with stress urinary incontinence: comparison of introital ultrasound and magnetic resonance imaging in vitro and in vivo. Ultrasound Obstet Gynecol 27(6):687–92

    Article  PubMed  CAS  Google Scholar 

  7. Chou CP et al (2008) Imaging of female urethral diverticulum: an update. Radiographics: a review publication of the Radiological Society of North America, Inc 28(7):1917–30

    Article  Google Scholar 

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Acknowledgements

We acknowledge Dr. R. K. Naidoo for her contribution in the clinical care of this patient; Dr. B. Rajashanker for the MRI images and Dr. K. Ward for her help and advice in the preparation of this manuscript

Conflicts of interest

D. Gopinath: None. F. M. Reid is a preceptor for Gynaecare. A. R. B. Smith: none

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Authors and Affiliations

  1. Warrell unit, St Mary’s Hospital, Manchester, M13 9WL, UK

    D. Gopinath, A. R. B. Smith & F. M. Reid

Authors
  1. D. Gopinath
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  2. A. R. B. Smith
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  3. F. M. Reid
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Corresponding author

Correspondence to D. Gopinath.

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Gopinath, D., Smith, A.R.B. & Reid, F.M. Periurethral abscess following polyacrylamide hydrogel (Bulkamid®) for stress urinary incontinence. Int Urogynecol J 23, 1645–1648 (2012). https://doi.org/10.1007/s00192-012-1768-1

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  • DOI: https://doi.org/10.1007/s00192-012-1768-1

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