Preliminary evaluation of calcium hydroxylapatite as a transurethral bulking agent for stress urinary incontinence

To evaluate the potential of calcium hydroxylapatite particles as a bulking material for the treatment of stress incontinence.

Ten women (mean age 68 years, range 60 to 82) with stress incontinence associated with intrinsic sphincter deficiency and limited hypermobility were treated with one (3 patients) or two (7 patients) injections of calcium hydroxylapatite particles and were followed up for 1 year subsequent to the last injection.

The mean total volume injected was 3.9 mL. No significant safety issues were identified with regard to local pain, infection, induration, or obstruction. Seven women reported substantial improvement using many fewer pads or none at all (3 patients) at 1 year, 2 women reported fewer pads, and 1 patient reported no change. The daily mean pad use declined from 2.59 to 1.64 and the mean 24-hour pad weight declined by more than 90% (104.9 versus 1.5 g). The mean Valsalva leak point pressure (VLPP) increased from 39 to 46 cm H(2)O at 12 months, with 2 patients dry on testing.

The results of this small initial study suggest that calcium hydroxylapatite particles have potential as a bulking agent for the treatment of stress incontinence.