Periurethral injection with polyacrylamide after previous TVT surgery.

Area of Science:

• Urology
• Gynecology
• Pelvic Floor Disorders

Background:

• Stress urinary incontinence (SUI) affects many women, often persisting after initial treatments like midurethral sling surgery.
• Recurrent or persistent SUI necessitates exploring alternative or adjunctive therapeutic options.
• Periurethral bulking agents offer a minimally invasive approach to manage SUI.

Purpose of the Study:

• To evaluate the clinical utility of periurethral bulking with polyacrylamide hydrogel in women with SUI.
• To assess outcomes in patients who previously underwent midurethral sling surgery.
• To determine cure rates, patient satisfaction, and complication profiles.

Main Methods:

• Registry study including 57 women with SUI post-midurethral sling surgery (2007-2019).
• Intervention: Periurethral bulking with polyacrylamide hydrogel (Bulkamid®).
• Outcomes: SUI cure, patient satisfaction, urgency urinary incontinence (UUI), and complications.

Main Results:

• A significant proportion of patients (72.9%) achieved SUI cure, with high satisfaction rates (73.7%).
• Complications were infrequent (1.5% per injection).
• New-onset UUI occurred in 8.8% of patients, while existing UUI improved or resolved in many.

Conclusions:

• Periurethral bulking with polyacrylamide hydrogel demonstrates favorable cure and satisfaction rates for SUI after midurethral sling surgery.
• The procedure is associated with a low complication rate.
• A notable risk of de novo overactive bladder symptoms exists in patients without prior UUI.