One-year outcomes of polyacrylamide hydrogel (Bulkamid) injection in women with stress and mixed urinary incontinence

Abstract

Purpose

This study aimed to evaluate the efficacy and safety following treatment with Bulkamid for stress urinary incontinence (SUI) or stress-predominant mixed urinary incontinence (MUI).

Methods

We retrospectively analyzed data of women diagnosed with SUI or stress-predominant MUI who underwent Bulkamid periurethral injection between November 2020 and January 2023 and completed 12 months of follow-up. The primary outcome of the study was to assess patient satisfaction, which was measured on a four-point scale, ranging from cured to worse, and through validated questionaries such as the International Consultation on Incontinence Questionnaire-short Form (ICIQ-UI SF) and Contilife Quality of Life questionnaire.

Results

Of the 70 patients included, 41 (59%) had MUI with predominant stress incontinence. Median age was 59 years (IQR 47–75), with a median BMI of 25 (18–40) and a median number of pregnancies of 2 (0–4). Forty-seven (67%) procedures were performed under sedation and 23 (33%) under local anesthesia. Forty-three (69%) women reported feeling cured or improved at 12 months follow-up and among them, 25 (40%) reported feeling cured. A total of 16 (23%) patients were subsequently treated, in detail 11 (16%) patients underwent MUS positioning, and 5 (7%) had an additional injection of Bulkamid. ICIQ and Contilife QoL showed a significant improvement at 1, 3, 6, and 12 months (all p < 0.001).

Conclusions

Bulkamid injections are an effective and safe treatment option for women with SUI or stress-predominant MUI, providing good outcomes at 12 months.