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Published on: January 7, 2019
Bulkamid for Recurrent SUI After Suburethral Sling Revision: Single-Center Study
Christina Sze1, Carolina Martinez Fernandez2, Maali LaFrance2
1Department of Urology, University of Texas Southwestern Medical Center.
Urogynecology (Philadelphia, Pa.)
|May 12, 2026
Summary
Bulkamid injections effectively treat recurrent stress urinary incontinence (SUI) after sling revision, particularly for isolated SUI. This minimally invasive option offers significant symptom improvement for many patients.
Area of Science:
- Urology
- Female Pelvic Medicine and Reconstructive Surgery
Background:
- Postoperative stress urinary incontinence (SUI) after suburethral sling revision is a common complication impacting quality of life.
- Polyacrylamide hydrogel (PAHG), marketed as Bulkamid, presents a minimally invasive treatment option for recurrent SUI, though data in this specific patient group is limited.
Purpose of the Study:
- To assess the safety and efficacy of Bulkamid injections for persistent or recurrent SUI following suburethral sling revision.
- To identify factors influencing treatment response in patients undergoing Bulkamid injections for post-sling revision SUI.
Main Methods:
- Retrospective, single-center study of 41 women treated with Bulkamid for SUI or stress-predominant mixed urinary incontinence (MUI) after sling revision (2019-2024).
- Incontinence severity evaluated using pad usage, Urogenital Distress Inventory-6 (UDI-6), Incontinence Impact Questionnaire-7 (IIQ-7), and patient-reported outcomes.
- Statistical analysis included nonparametric and categorical methods with significance set at P<0.05.
Main Results:
- Median pad use decreased significantly post-injection (2 to 0, P=0.01).
- UDI-6 scores improved significantly (median 66.7 to 44.4, P=0.005), with notable improvements in urinary frequency and pain.
- Symptom improvement was significant for SUI only (P=0.016) but not for MUI (P=0.258).
Conclusions:
- Bulkamid injection is a safe and effective minimally invasive treatment for recurrent SUI after suburethral sling revision.
- Patients with isolated SUI and those receiving a single injection experienced the greatest benefit.
- Mixed urinary incontinence or prior synthetic slings may be associated with reduced treatment efficacy.
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