Journal of Urological Surgery (Dec 2023)

Minimally Invasive Treatment of Female Stress Urinary Incontinence with Polyacrylamide Hydrogel (Bulkamid®): Outcomes of a Contemporary Turkish Cohort Including Cases with Mixed Urinary Incontinence and Previously Failed Prior Surgery

  • Ersin Köseoğlu,
  • Mert Kılıç,
  • Ömer Acar,
  • Tufan Tarcan

DOI
https://doi.org/10.4274/jus.galenos.2023.2023-5-3
Journal volume & issue
Vol. 10, no. 4
pp. 334 – 340

Abstract

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Objective: We aimed to describe the outcomes and patient satisfaction (PS) rates of transurethral polyacrylamide hydrogel (PAHG) (Bulkamid®) injection for the treatment of female stress urinary incontinence (SUI) in a Turkish cohort. Materials and Methods: Twenty-two patients who underwent injection primarily or secondarily between December 2019 and March 2023 due to SUI or stress-predominant mixed urinary incontinence (MUI) were retrospectively evaluated. All patients underwent an invasive urodynamic study (UDS) before the procedure. The primary outcome was treatment success (TS), defined as no pad use, negative International Continence Society (ICS) uniform cough stress test (CST), and no SUI on International Consultation on Incontinence Questionnaire-Short Form question 6. The secondary outcome was PS. Results: The median age was 61.5 (41-84) years. Six patients had stress-predominant MUI and 15 had SUI. PAHG injection was the primary and secondary treatment in 17 and 4 patients, respectively. ICS uniform CST was positive in all patients. In 8 patients, intrinsic sphincter deficiency (ISD) was detected during UDS. One patient developed transient urinary retention after surgery. At a median follow-up of 17 (1-38) months, the overall TS rate was 85.7%. Success rates in primary vs. secondary setting and pure SUI vs. MUI were 88.2% vs. 75% and 80% vs. 100%, respectively. The overall PS rate was 90%. Satisfaction rates in the primary vs. secondary setting and pure SUI vs. MUI were 93.6% vs. 75% and 85.7% vs. 100%, respectively. TS and PS rates were 100% in all patients with ISD. Conclusion: PAHG injection proved to be a safe and effective minimally invasive treatment for pure stress and stress-predominant MUI in both primary and secondary settings.

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