Peri-Urethral Bulking Injections

Why is it done?

• Where Intrinsic Sphincter Deficiency has been proved after failed previous sling.

How is it done?

• This procedure is done under a spinal / general anesthetic, as decided by the anesthetist.
• The legs will be elevated into the lithotomy position.
• This procedure is done cystoscopically.
• 3 peri-urethral injections are made with injection of Macroplastique/ Bulkamid until the urethral lumen closes.
• Your urine output will be measured each time you urinate, and the residual will be measured. (Patients will be required to do this up to 3 times.)
• If the residual amount of urine is more than 1/3 of the total bladder capacity, the patient may have to self-catheterize, until the residual volume is acceptable.
• Prophylactic antibiotics will be given to prevent infection.

What to expect after the procedure?

• Any anesthetic has its risks, and the anesthetist will explain all such risks.
• Complications of hemorrhaging and urine retention.
• Patients will have no catheter when they wake up.
• If you cannot urinate after 2-3 attempts, an in-out catheter may be inserted to empty your bladder.
• You may be required to self-catheterize for a week or two.
• NB! Each person is unique and for this reason symptoms may vary!

What next?

• Patients will have a trial of void without catheter after the procedure
• Patients will be discharged as soon as they can completely empty the bladder.
• Patients may be required to self-catheterize for a week or two (rarely necessary).
• Patients may initially suffer from urge incontinence, but this will improve within the next 6 weeks.
• Allow 6 weeks for symptoms to stabilize.
• You may not experience a full return of continence, and the effects may worsen with time.
• More than 1-2 treatments may provide the desired effects.
• There may be some blood in the urine. This can be remedied by drinking plenty of fluids until it clears.
• On discharge a prescription may be issued for patients to collect.
• Patients are to schedule a follow-up appointment in 6 weeks.
• Please direct all queries to Dr Schoeman’s rooms.
• PLEASE CONTACT THE HOPSITAL DIRECT WITH ANY POST-OPERATIVE CONCERNS AND RETURN TO THE HOSPITAL IMMEDIATELY SHOULD THERE BE ANY SIGNS OF SEPSIS.

Download Information Sheet

Wes Peri-Urethral Bulking