Patient Experience With Office-Based Polyacrylamide Hydrogel Injection

Stress urinary incontinence (SUI) is prevalent and has a significant effect on quality of life. Urethral bulking with polyacrylamide hydrogel (PAHG) provides a minimally invasive treatment option for SUI caused by intrinsic sphincter deficiency. However, limited data exist evaluating patient experience with in-office PAHG injection performed without sedation.

The objectives of this study were to compare anticipated and experienced pain with in-office PAHG injection under local anesthesia and to assess patient satisfaction with the procedure.

This prospective study included patients undergoing in-office PAHG injection. Participants completed a visual analog scale (VAS) assessing anticipated pain before the procedure and pain experienced afterward. Participants were contacted within 1 week to assess satisfaction. The change in VAS score was calculated to evaluate differences between anticipated and experienced pain.

Forty patients participated in the study with a median age of 49 years and mean body mass index of 32.7. The median anticipated and experienced VAS pain scores were 5.15 (3.40, 7.90) and 7.00 (5.90, 8.95), respectively, corresponding to a median increase of 1.50 (-0.35, 2.85, P=0.002). Most participants reported they would be willing to undergo the procedure again. There was no statistically significant difference in the change in VAS score based on satisfaction with the procedure.

Participants reported greater discomfort than anticipated with in-office PAHG injection; however, most remained satisfied with the procedure and would be willing to undergo it again. These findings support the feasibility and acceptability of office-based PAHG injection while emphasizing the importance of preprocedure counseling regarding expected discomfort.