Urogynecology and Pelvic Surgery

Urethral bulking

What is urethral bulking?

Urethral bulking is an in-office procedure that can treat stress urinary incontinence (SUI), which is when you leak urine when sneezing, laughing, coughing or exercising. It is a very common condition that occurs in 1 in 3 women.

Urethral bulking agents are injected around the urethra (the tube where urine comes out of your body) to narrow the opening so less urine leaks out. This may decrease the muscle strength needed to close off the urethra.

How is the procedure performed?

The procedure can be done in the clinic with local numbing medicine, but you may have less pain and a potentially better outcome by using conscious sedation at a surgical center. Conscious sedation uses a mix of medicines to help you relax and block pain, so you awake and aware without feeling discomfort. You may not remember the procedure.

Anesthetic (numbing) jelly is applied to the urethra and allowed to work for about 5 minutes. Then, your doctor will insert a thin lighted tube, called a cystoscope, into your urethra and bladder. The cystoscope has a camera on the end so your doctor can look at your bladder and urethra. Next, a very thin needle will inject the bulking agent into the urethra walls near the neck of your bladder.

How long do effects last?

Some urethral bulking agents have lasted up 8 years in clinical trials, and some patients are considered cured. Most will at least experience symptom improvement. If you begin leaking urine again, talk to your doctor about repeat injections.

How long does the procedure take?

Overall, the procedure takes about 10 minutes to perform. Before you go home, you will be asked to urinate to see if you can empty your bladder adequately.

What are the risks?

Urethral bulking is a very low-risk procedure, but talk to your doctor about possible risks, including:

  • Urinary tract infection
  • Blood in the urine
  • Pain during the injection (if performed in clinic with only local anesthesia)
  • Temporary difficulty emptying the bladder

What should I expect afterward?

We recommend drinking extra fluids for 24 hours after urethral bulking. Some patients might have temporary burning or see some blood when they urinate. If these symptoms last more than 24 hours, contact your doctor (478) 633-5300.

Will my insurance company cover urethral bulking agents?

Check your insurance plan benefits to see if your policy covers urethral bulking. If it does, our office will help you get prior authorization if your insurance policy requires it. If you have further questions, contact your insurance carrier.