Stress incontinence is a little, dare I say, stressful, and I’m not too fond of stress. And I would bet my bottom dollar that you don’t like stress either! One way to stress less about stress incontinence is by finding solutions to it, such as urethral bulking. Here, we’re going to explain what urethral bulking is and how it just might help you.
What is Urethral Bulking?
Urethral bulking is a procedure that involves injecting a bulking agent around the urethra. The urethra is the tube that gives pee a ride from the bladder to the exterior of the body. With this procedure, a doctor will narrow the urethra with the hope that you’ll leak less because the tube is thinner. A thinner tube, which is created by a thicker urethral wall, doesn’t allow as much urine to come through. Therefore, it makes it easier to hold back urine when you sneeze, cough, or do any other activity that puts stress on your bladder.
In some cases, healthcare professionals perform urethral bulking to close an unwanted hole in the urethra that causes urine to come out.
Who Is A Good Candidate For Urethral Bulking?
Now that you know such a procedure exists, you’re probably wondering if you’d make a good candidate. Overall, urethral bulking is a potentially good option for those with stress incontinence. Especially if your stress incontinence is mainly due to a weakened sphincter surrounding the urethra. The sphincter is a muscle that acts as a gatekeeper and lets pee leave your body. When the sphincter is weak, it can’t keep urine in as well as it should. So, urethral bulking helps to keep it closed. The most suitable candidates for urethral bulking include the following:
- Women that wish to avoid sling surgery
- Ladies that are not fit for surgery or anesthesia
- Women that want to have more children
Who Is Not A Good Candidate?
Individuals that are not good candidates for urethral bulking include:
- Those that currently have a urinary tract infection
- Women that have trouble emptying their bladder
- People that have an obstruction in the urethra
How Is Urethral Bulking Done?
Urethra bulking is usually done in a doctor’s office and doesn’t take long to do. Most procedures are done in 20 minutes and allow you to return home on the same day. However, you’ll likely spend at least 1 to 2 hours at your doctor’s office. Here’s what you can expect:
Before the procedure, you’ll need to have a urine test to make sure you don’t have a UTI. If you’re in the clear, you’ll undress from the waist down and lie on the exam table. Similar to undergoing a pelvic exam, you’ll put your feet in stirrups and cover yourself with a sheet. After that, they’ll clean your genital area with an antiseptic solution and insert a numbing gel into your urethra. You might also be given an antibiotic to reduce potential infection.
Once you’re numb, your healthcare provider will start the procedure. They’ll use a cystoscope so they can see inside the urethra and inject the bulking agent just below the neck of the bladder. Collagen is the most commonly used bulking agent, but sometimes healthcare providers use another type of water-based gel. You can expect your provider to insert the bulking agent into 2 to 4 areas to thicken the urethral wall.
Recovery from a Urethral Bulking Injection
After you’ve completed the procedure and the numbing has worn off, they’ll ask you to pee. Once you successfully pee and leave the hospital, you’ll be on the road to recovery. It usually takes a few days before the bulking agents start to work, so you may still notice some leaking. Some women even feel like they have to pee more frequently for the first few days after the procedure.
It’s also not uncommon to see a little blood in your urine or to feel burning or stinging. Fortunately, there are some over-the-counter medications you can take to help with the burning. For additional relief, try taking a warm bath or putting a warm washcloth over your genital area. You’ll be glad to know that there aren’t any activity restrictions following the procedure so you can proceed with your normal routine.
Are There Any Risks?
In some cases, the bulking agent procedure makes it challenging to empty the bladder completely. However, this happens in less than 10% of women. For those that do have trouble, their provider will teach them how to catheterize themselves. Other risks, which are typical for any procedure, include:
- Anesthetic risks (if you receive local or general anesthesia)
Bulking Agents and Stress Incontinence
You might consider bulking agents if you have stress incontinence and are looking for a reasonably low-risk procedure. The procedure has a 60 to 70 percent success rate, but success doesn’t exactly equal “no leaks.” The goal of urethral bulking is to narrow the urethra, so you leak less. Which means, it’s probably a good idea to keep a few bladder leak pads on hand for those moments (pssst, Lily Bird can help with that!).
In addition, urethral bulking is not a permanent solution. The effects do wear off over time, but you can expect the injections to work for approximately 6 to 24 months. It’s not uncommon for people to get the procedure again.
By Jessica Thomas, MPH