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Bladder Neck Bulking Injections

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22/08/2013

BLADDER NECK BULKING INJECTIONS


Bladder neck collagen injections

A variety of agents can be injected into the bladder neck to provide tissue bulking, thus improving the seal at the bottom of the bladder, supporting the closure mechanism and reducing urinary incontinence.

When are the bladder neck injections performed?

Injections of bulking agents around the urethra and the bladder neck are used for treating stress urinary incontinence.

This procedure has a lower success rate than some other operations available and we therefore do not commonly offer this treatment as a first choice in patients.

However, bulking injections have a very low complication rate and can be performed under local anaesthetic.

We find it suitable for elderly women who are not fit for more invasive treatments and for younger women who are planning to have more children, they usually defer more invasive treatment until childbirth is complete.

How does it work?

When bulking agent is injected into the tissue around the urethra, it adds bulk and support which helps it close more tightly and so prevent urine leakage. The injections may need repeating because the body absorbs some of the material. The length of time between injections varies. Some need to be re-injected after a few months and some after a few years.

What does the operation involve?

The bladder-neck bulking injections can be given under a local, spinal (like epidural) or general anaesthetic. The procedure takes approximately 10-15 minutes and is a day-case procedure. A fine needle is inserted into the bladder through a cystoscope and the bulking agent is injected around the bladder neck and urethra.

What is the recovery after surgery like?

The operation is performed as a day-case. Therefore, the patient goes home the same day. Some women may experience some discomfort when passing urine for 24-48 hours following the operation and may find traces of blood in the urine. A small number of patients (1 in 100) will develop a urinary tract infection, which can be treated with a course of antibiotics. Drinking plenty of fluid after the operation should prevent these problems.

Contraindications
Periurethral bulking agents should not be used in the setting of pure urge incontinence or bladder outlet obstruction. A patient with mixed incontinence (eg, SUI and urge incontinence) in whom the urge component is the predominant problem may elect to address the symptoms of bladder overactivity before bulking up the urethra but may find that treatment of the SUI also improves the urge incontinence. Patients with a hypersensitivity to collagen, noted on skin testing before injection, should not undergo this type of therapy


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