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

D Gopinath1, A R B Smith, F M Reid

  • 1Warrell unit, St Mary's Hospital, Manchester M13 9WL, UK. DEEPS781@HOTMAIL.COM

International Urogynecology Journal
|April 25, 2012
PubMed

Insights

This case report details the first instance of a periurethral abscess after Bulkamid injection for stress urinary incontinence (SUI). While initially successful, the complication required surgical drainage, leading to recurrent SUI.

Area of Science:

  • Urology
  • Gynecology
  • Medical Device Complications

Background:

  • Bulkamid is a periurethral bulking agent for stress urinary incontinence (SUI).
  • Periurethral abscesses are a known complication of bulking agents.
  • This study presents the first reported case of a periurethral abscess following Bulkamid injection.

Observation:

  • A patient with prior transobturator tape (TOT) and vaginal mesh repair received Bulkamid for SUI.
  • The patient reported complete SUI cure at 6 weeks post-injection.
  • A periurethral abscess developed, diagnosed and monitored via transperineal ultrasound.

Findings:

  • The abscess was located anterior and lateral to the urethra, separate from the TOT.
  • Magnetic resonance imaging (MRI) delineated the abscess extent into the retropubic space.
  • Surgical vaginal drainage resolved pain but resulted in SUI recurrence.

Implications:

  • This case highlights a rare but serious complication of Bulkamid injections.
  • It underscores the importance of vigilant monitoring for abscess formation after bulking agent use.
  • Further research may be needed to assess the long-term safety profile of Bulkamid, especially in patients with prior pelvic reconstructive surgery.

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