Efficacy of polyacrylamide hydrogel for female urinary incontinence: outcome of a single centre

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.