EFFICACY OF POLYACRYLAMIDE HYDROGEL FOR FEMALE URINARY INCONTINENCE: OUTCOME OF A SINGLE CENTRE

Authors

  • Mickey Buckingham University Hospital Lewisham, London, UK
  • Mahbuba Sultana Ashford and St Peter’s Hospitals NHS Foundation Trust, Chertsey, UK
  • James M Thomas Ashford and St Peter’s Hospitals NHS Foundation Trust, Chertsey, UK
  • Vasanth Andrews University Hospital Lewisham, London, UK https://orcid.org/0000-0002-9053-0691

DOI:

https://doi.org/10.21272/eumj.2023;11(2):149-154

Keywords:

polyacrylamide hydrogels, urinary incontinence, urinary stress incontinence

Abstract

Introduction: Periurethral injection with polyacrylamide hydrogel (PAHG, Bulkamid®) is a minimally invasive treatment option to be considered for women with stress urinary incontinence. The manufacturer recommends injecting between 1.5 ml and 2 ml periurethrally. This study aims to evaluate the long-term efficacy of PAHG, and to determine whether there is a correlation between the volume of PAHG injected and the outcome in terms of symptoms.

Methods: A retrospective study was conducted between 2011 and 2018. Patients were contacted by telephone and the International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form (ICIQ-UI SF) was used to assess their symptoms. A linear regression analysis test was performed to assess the correlation between the outcome and the volume of PAHG injected.

Results: One hundred and fifteen PAHG injections were performed on 101 patients. The volume of PAHG injected ranged from 0.8 ml to 3 ml. Two patients reported procedure-related complications. Of the patients that attended their three-month follow-up, 62 (58.5%) patient-episodes reported an improvement. 62 patients were contacted by telephone and the median length of follow-up was 37.5 months. An improvement in the ICIQ-UI SF score was observed in 45.8% of patients with a mean improvement of 4 points. The volume of PAHG injected did not affect the outcome. 31% also reported a benefit with PAHG five years after their injection following previous incontinence surgery.

Conclusions: PAHG injection is safe and improves symptoms of urinary incontinence at up to 7.5 years in 45.8% of women. PAHG is also useful after previous incontinence surgery. The volume of PAHG injected did not influence the outcome.

Downloads

Download data is not yet available.

References

Minassian VA, Drutz HP, Al-Badr A. Urinary incontinence as a worldwide problem. Int J Gynaecol Obstet. 2003;82(3):327-38. https://doi.org/10.1016/s0020-7292(03)00220-0

Minassian VA, Stewart WF, Wood GC. Urinary incontinence in women: variation in prevalence estimates and risk factors. Obstet Gynecol. 2008;111(2 Pt 1):324-31. https://doi.org/10.1097/01.AOG.0000267220.48987.17

Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Am J Obstet Gynecol. 2002;187(1):116-26. https://doi.org/10.1067/mob.2002.125704

Lose G, Mouritsen L, Nielsen JB. A new bulking agent (polyacrylamide hydrogel) for treating stress urinary incontinence in women. BJU Int. 2006;98(1):100-4. https://doi.org/10.1111/j.1464-410X.2006.06205.x

Christensen LH, Nielsen JB, Mouritsen L, Sorensen M, Lose G. Tissue integration of polyacrylamide hydrogel: an experimental study of periurethral, perivesical, and mammary gland tissue in the pig. Dermatol Surg. 2008;34(1):68-77; S77. https://doi.org/10.1111/j.1524-4725.2008.34246.x

Toozs-Hobson P, Al-Singary W, Fynes M, Tegerstedt G, Lose G. Two-year follow-up of an open-label multicenter study of polyacrylamide hydrogel (Bulkamid®) for female stress and stress-predominant mixed incontinence. Int Urogynecol J. 2012;23(10):1373-8. https://doi.org/10.1007/s00192-012-1761-8

Sokol ER, Karram MM, Dmochowski R. Efficacy and safety of polyacrylamide hydrogel for the treatment of female stress incontinence: a randomized, prospective, multicenter North American study. The Journal of urology. 2014;192(3):843-9. https://doi.org/10.1016/j.juro.2014.03.109

Kasi AD, Pergialiotis V, Perrea DN, Khunda A, Doumouchtsis SK. Polyacrylamide hydrogel (Bulkamid®) for stress urinary incontinence in women: a systematic review of the literature. Int Urogynecol J. 2016;27(3):367-75. https://doi.org/10.1007/s00192-015-2781-y

Contura. Bulkamid standard operating procedure. 2018. Available from: https://bulkamid.com/wp-content/uploads/2019/03/BULK_2018_041.2_SOP_12.04.18.pdf.

Abrams P, Avery K, Gardener N, Donovan J, Board IA. The International Consultation on Incontinence Modular Questionnaire: www.iciq.net. The Journal of urology. 2006;175(3 Pt 1):1063-6; discussion 1066. https://doi.org/10.1016/S0022-5347(05)00348-4

Pai A, Al-Singary W. Durability, safety and efficacy of polyacrylamide hydrogel (Bulkamid®) in the management of stress and mixed urinary incontinence: three year follow up outcomes. Cent European J Urol. 2015;68(4):428-33. https://doi.org/10.5173/ceju.2015.647

Zivanovic I, Rautenberg O, Lobodasch K, von Bunau G, Walser C, Viereck V. Urethral bulking for recurrent stress urinary incontinence after midurethral sling failure. Neurourol Urodyn. 2017;36(3):722-726. https://doi.org/10.1002/nau.23007

Downloads

Published

2023-06-18

How to Cite

Buckingham, M. ., Sultana, M. ., Thomas, J. M. ., & Andrews, V. . (2023). EFFICACY OF POLYACRYLAMIDE HYDROGEL FOR FEMALE URINARY INCONTINENCE: OUTCOME OF A SINGLE CENTRE. Eastern Ukrainian Medical Journal, 11(2), 149–154. https://doi.org/10.21272/eumj.2023;11(2):149-154

Issue

Vol. 11 No. 2 (2023): EASTERN UKRAINIAN MEDICAL JOURNAL

Section

ORIGINAL RESEARCH. SURGERY

License

Copyright (c) 2023 Mickey Buckingham, Mahbuba Sultana, James M Thomas, Vasanth Andrews

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.