Urethral Bulking Chattanooga TN

What is urethral bulking?

Stress Urinary Incontinence (SUI) involves the leakage of urine that occurs with straining such as when you cough, sneeze, lift, exercise or even bend over. There are many different treatment options available to patients with SUI ranging from pelvic floor exercises to surgeries. One surgical treatment for SUI is Urethral Bulking.

Urethral Bulking is a procedure in which a material is injected into the urine tube (urethra) to “bulk” it, partially closing the tube and making it easier for the muscles that control urine leakage to close the urethra completely. This may improve or even eliminate leakage associated with exertion such as coughing or exercise.

What can I expect during urethral bulking?

Urethral bulking may be performed in the office or under sedation in the operating room, depending on your preference and any health concerns. A small scope (called a cystoscope) is inserted into the urine tube (urethra) so that we can see where to inject the material. Using a needle passed through the cystoscope, the bulking material is injected into the wall of the urine tube. This added “bulk” to the urethra helps the muscles that keep you continent to close more completely, reducing your leakage.

After the injection, if performed in the operating room, you will be given plenty of time to fully wake up. Whether performed with or without sedation, you will then have time to try to urinate on your own. If you have difficulty urinating, a small tube called a catheter may be briefly placed in the urine tube and then removed. This may help you to empty your bladder by opening up the urine tube slightly. Patients are usually able to go home the same day as the procedure, and can return to work within a day or two.

What is a Bulking Agent?

Urethral bulking is a common clinical procedure that’s been used for over a century as a solution for stress urinary incontinence. Over the years, several bulking agents have been used. Examples include collagen protein, hydrogels, and micro-particles of biocompatible materials. Different bulking agents work in different ways. An agent that is made up of micro-particles, for instance, may narrow the urethral opening by causing a reactive change in the body’s natural tissue (an inflammatory response). Other agents narrow the opening by increasing the volume of the tissue in the urethral wall.

The experienced medical team at UT Urology has helped many patients deal with stress urinary incontinence and other urological issues. We continue to expand our knowledge and bring in new treatments as they are proven safe and effective. If you are a good candidate for urethral bulking, your doctor may discuss the various options in bulking agents that are available at the time of your consultation. You can trust that whatever choices are presented, they will have been thoroughly tested in clinical trials.

How well does urethral bulking work?

During the first year after treatment, the majority of patients are improved with less overall Stress Urinary Incontinence (SUI). However, the majority of patients are not completely dry during the first year after urethral bulking. The long-term benefits of urethral bulking are less well known but most patients will notice a decrease in the benefits from urethral bulking over time. Many patients will require repeat injections to maintain benefit, even within the first year after treatment.

Can Urethral Bulking Help Reduce Overactive Bladder?

Urethral bulking is a common nonsurgical treatment for stress urinary incontinence. This is a different condition than overactive bladder and one that responds well to urethral bulking. In stress urinary incontinence, it is the pelvic floor and the urethra that are responsible for accidental leaks during times of physical exertion, such as a sneeze. In overactive bladder, the issue exists in the bladder itself, with urine leaking as a result of a sudden, strong urge to urinate. Your doctor can discuss treatment options for you based on the type of urinary incontinence you have and its underlying cause.

What are the side effects with urethral bulking?

Many patients will have difficulty urinating immediately after urethral bulking and will require the brief placement and removal of a small tube (catheter) before leaving the hospital or office. A smaller number of patients will have trouble emptying their bladder for longer, though this typically resolves within a couple of weeks.

Patients may also note pain with urination for a few days after the bulking procedure or may find that they have to urinate more frequently. Again, these symptoms typically resolve within the first weeks after the procedure. Patients may also require treatment for a urinary tract infection.

The main advantage to urethral bulking is avoidance of a more-invasive surgery or, in some patients, anesthesia. Patients who either cannot tolerate or prefer to avoid a more-invasive surgery may want to consider urethral bulking as an option. When compared to other surgical therapies for SUI, urethral bulking is usually not as successful at treating leakage and does not last as long.

Will I Need Time Off to Recover After the Urethral Bulking Procedure?

You may want to take a few days off following your urethral bulking treatment. Doing so can enable you to deal with side effects like difficulty passing urine if this occurs. Your doctor may recommend a few aftercare instructions based on your treatment, overall health, and initial response to the procedure as it has affected urination (or not). You may be advised to:

• Avoid strenuous activities for two to three days.
• Take short walks only and, if you must walk upstairs, move slowly.
• Do not drive for at least 24 hours after the procedure.
• Do not use tampons for minor post-treatment bleeding or spotting. If this occurs, use pads. This side effect should resolve within one week if it develops.
• Wash the genital area with soap starting the day after the procedure. You may shower normally and should pat the area dry.
• Avoid soaking in a tub, using a hot tub, or swimming for one week.

How Successful is Urethral Bulking for Stress Urinary Incontinence?

According to studies, urethral bulking improves or eliminates the symptoms of stress urinary incontinence in 60 to 70 percent of patients. The results of this treatment do tend to diminish over time. It’s possible to repeat the injection a second time if needed to achieve optimal results. Some patients repeat this injection within one year of their first.

What is my next step?

At UT Urology, we have specialized in providing the most advanced care available for the treatment of Urinary Incontinence. Our expertise allows you to choose from among several options for treatment of your incontinence, finding the treatment that is right for you. We have the only Urologists in the region who have completed fellowship training including a focus on incontinence. We routinely treat patients with even the most complicated incontinence problems including those who have failed prior therapies or have complications from prior procedures.

Contact us today for your evaluation and take the first step toward gaining better control over your incontinence in Chattanooga, and East Ridge, TN.