Urethral Bulking for Stress Urinary Incontinence or Mixed Incontinence in Women Not Suitable for Treatment With a Midurethral Sling: 5-Year Follow-Up

Abstract

Aim: To compare outcome of injection with the bulking agent polyacrylamide hydrogel (PAHG) with no treatment in women with urinary incontinence who were not candidates for treatment with a midurethral sling. Methods: Women were randomized to treatment with PAHG or no treatment. After 2 months follow-up the women in the non-treatment group were also given PAHG treatment. All patients were then followed for 12 months. Patients were assessed with a patient satisfaction questionnaire, the UDI-6 (lower urinary tract symptoms) and IIQ-7 (quality of life). A new questioner was sent after 5 years. Results: At 2 months, IIQ-7 scores decreased by 55% and the UID-6 by 38% in women in the treated group compared with -4% and 2%, respectively in the non-treatment group. A total of 63% of patient were much satisfied/ satisfied in the treatment group compared with 19% in the non-treatment group. The 12-month follow-up showed a subjective satisfaction rate of 62%. The objective results show that women who were satisfied (n = 18) had a decrease in IIQ-7 of 61% and UID-6 of 41% compared with 20% and 10% in patients who were not satisfied (n = 11). At a mean (range) follow-up of 5 years (3–7), 44% of patients were still satisfied with treatment results. Conclusion: Bulking treatment with PAHG can be offered to patients not suited to treatment