Introduction
Managing female stress urinary incontinence requires balancing treatment choice with patient expectations. Urethral bulking with LA Bulkamid offers effective, minimally invasive care, often requiring repeat procedures. Our outcomes were compared with Freitas et al. (2020). Local anaesthesia reduces costs, with GA cystoscopy estimated at £500 per procedure
Methods
Bulkamid injections under local anaesthesia (LA) are our standard approach for managing female stress urinary incontinence. We prospectively collected data from 29 patients treated between November 2021 and March 2023, using ICIQ-UI, Overactive bladder symptom questionnaires, bladder diaries, and pre/postprocedure forms. All had urodynamic stress incontinence. Most (93.1%) tolerated LA; 6.9% opted for general anaesthesia. Thirteen patients (44.8%) were first-time recipients, while 16 (55.2%) underwent repeat injections. Baseline ICIQ-UI scores ranged from 21–11, improving to 18–6 post-treatment. No intra-operative complications occurred. Patients were reviewed at two weeks by a functional urology nurse, with further PROMs and physician assessment at 3–4 months.
Results
20 patients (68.9%) reported significant improvement, 3 patients reported partial improvement (10.3%), and 2 patients reported no improvement (6.8%). Four patients were not contactable post-op. Results show 93% of contactable patients had partial or significant improvement. This is unchanged to our previous data using general anaesthetic for all patients.
Conclusion
These findings support the feasibility of performing intraurethral bulking under LA for female stress urinary incontinence, demonstrating favourable clinical outcomes while offering significant cost savings in comparison to GA urethral bulking procedures.
Authors
Don Wijayasuriya
Royal Gwent Hospital, Newport, United Kingdom
Wail Mohomed
Royal Gwent Hospital, Newport, United Kingdom
Paulette Hussain
Royal Gwent Hospital, Newport, United Kingdom
Coral Seymour
Royal Gwent Hospital, Newport, United Kingdom
Maike Eylert
Royal Gwent Hospital, Newport, United Kingdom