Bulking Agents to Restore Urinary Continence

collagen used a bulking agent

Collagen is one of several bulking agents that may used to help restore continence.

Injections of one of several kinds of bulking agents is an outpatient procedure that may be used to restore urinary continence.  In this procedure a bulking agent (such as collagen, silicon and Teflon) is injected into the neck of the bladder.  This bulks the bladder neck and helps compress the urethra (the tube that leads urine out of the body), and thus helps to prevent urinary leakage.

The injection of bulking agents can be used on men or women with a non-severe type of stress urinary incontinence, often as the result of prostate surgery or childbirth (respectively).

Many people like to try this treatment because it is less invasive than surgery. And many people have good success with this treatment. It is generally considered to be a low-risk procedure.  However, this procedure is not without complications, and in only a small number of cases are there severe adverse reactions.  Researchers continue to try to locate the best possible bulking agent, to reduce complications.  Most complications are easily reversed with conservative measures.

Injections of a bulking agents (biocompatible materials) is a short-term solution, so it may be ideal for treatment of incontinence from damage to the urethra after childbirth or after prostate surgery.  But this means that if incontinence returns, the injections must be repeated by your professional healthcare provider anywhere from every couple of months to once a year, depending on the individual and the severity of the incontinence.

Currently, the following products are available:

  • Calcium hydroxyl apatite (Coaptite®)
  • Carbon coated zirconium (Durasphere®)
  • Polydimethylsiloxane elastomer (Macroplastique®)
  • Polyacrylamide hydrogel (Bulkamid®)
  • PDMS-U (Urolastic ®), a silicone gel that polymerizes when injected

Most people get a significant reduction in the amount of urinary leakage associated with activities,  but they may still need to wear some absorbent protection with this treatment.

Medical Reviewer: Karen Sasso, MSN, RN, APN, CCCN-AP

Karen Sasso, MSN, RN, APN, CCCNMs. Sasso is the Program Manager/Urogynecology Clinical Nurse specialist at NorthShore University Health System in Evanston , Illinois. She received her nursing diploma from the Medical College of Pennsylvania in Philadelphia, a Bachelor of Science degree in nursing at Alverno College, Milwaukee, Wisconsin, and a Master of Science in Nursing at the University of Wisconsin-Milwaukee.  Her clinical practice involves the evaluation and treatment of women with urinary incontinence, voiding dysfunction, and pelvic floor disorders. She has extensive experience in clinical research for the treatment of women with stress urinary incontinence, detrusor overactivity and genital prolapse. Ms. Sasso has authored and coauthored articles on female urinary incontinence, genital prolapse and treatment options. She coauthored a book chapter published in Textbook of Female Urology and Urogynecology. She has presented at numerous symposia within the United States and abroad.  She is a reviewer for the journal Urologic Nursing, a committee member for the Wound, Ostomy and Continence Nursing Certification Board and a Project Advisory Council member for the National Association for Continence. She is a Certified Continence Care Nurse (CCCN) and licensed in the State of Illinois as an Advanced Practice Nurse. She was presented with the 2004 Continence Care Champion Award by the National Association for Continence and the Urologic Nursing Journal’s 2006-2007 Literary Excellence Award and in 2013 received Urologic Nursing Outstanding Reviewer Award.

Posted in Treatments & Management for Incontinence and tagged , , , .