DOI: 10.1097/ju9.0000000000000474 ISSN: 2771-554X

Bulkamid Injections for Urinary Incontinence: A Retrospective Case Series of Reintervention Rates

Lauren Henry, Sooah Ko, Sydney Sahudin, Chase Schlesselman, Eliza DeFroda

Introduction:

Bulkamid is a urethral bulking agent commonly used as a minimally invasive option for stress urinary incontinence (SUI), offering a less invasive alternative to surgical intervention. However, concerns regarding durability and the need for repeat interventions persist. This retrospective study evaluates reintervention rates, subjective symptom improvement, objective changes in pad usage, and the association between patient comorbidities and treatment response in a real-world clinical cohort.

Methods:

A retrospective review was performed of 56 female patients who underwent Bulkamid injections between January 2023 and March 2025. Chart review focused on urology procedural notes and pre/post procedure appointments. Data collected included age, body mass index (BMI), race, comorbidities, type of incontinence, incontinence symptoms, prior failed incontinence treatments, pad usage before and after bulking, and number of injections.

Results:

In our study, 35.7% of patients required more than one Bulkamid injection, including 10.7% who required 3 or more and 3.6% who required 4 or more. Among patients with available follow-up after the initial injection, 65.2% reported subjective symptom improvement, while 34.8% reported no improvement or worsening. Overall, 17.9% of patients had no available follow-up. Patients with mixed urinary incontinence demonstrated higher improvement rates compared with those with pure SUI (69.2% vs 47.1%, OR 2.50, P = .11). Patients with BMI ≥ 35 and those with diabetes or prediabetes demonstrated lower odds of improvement, although these differences were not statistically significant.

Conclusions:

The results highlight the overall reintervention rate for Bulkamid, offering insight into its durability and potential for retreatment, especially in populations with comorbidities such as diabetes or obesity. Expansion of these data aids in clinical prediction of patient outcome and may help inform patient counseling and treatment selection.

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