One-year outcomes of polyacrylamide hydrogel (Bulkamid) injection in women with stress and mixed urinary incontinence

Purpose: This study aimed to evaluate the efficacy and safety following treatment with Bulkamid for stress urinary incontinence (SUI) or stress-predominant mixed urinary incontinence (MUI).

Methods: We retrospectively analyzed data of women diagnosed with SUI or stress-predominant MUI who underwent Bulkamid periurethral injection between November 2020 and January 2023 and completed 12 months of follow-up. The primary outcome of the study was to assess patient satisfaction, which was measured on a four-point scale, ranging from cured to worse, and through validated questionaries such as the International Consultation on Incontinence Questionnaire-short Form (ICIQ-UI SF) and Contilife Quality of Life questionnaire.

Results: Of the 70 patients included, 41 (59%) had MUI with predominant stress incontinence. Median age was 59 years (IQR 47-75), with a median BMI of 25 (18-40) and a median number of pregnancies of 2 (0-4). Forty-seven (67%) procedures were performed under sedation and 23 (33%) under local anesthesia. Forty-three (69%) women reported feeling cured or improved at 12 months follow-up and among them, 25 (40%) reported feeling cured. A total of 16 (23%) patients were subsequently treated, in detail 11 (16%) patients underwent MUS positioning, and 5 (7%) had an additional injection of Bulkamid. ICIQ and Contilife QoL showed a significant improvement at 1, 3, 6, and 12 months (all p < 0.001).

Conclusions: Bulkamid injections are an effective and safe treatment option for women with SUI or stress-predominant MUI, providing good outcomes at 12 months.