Bulking injections effective even after radiotherapy

This study examined the effects of polyacrylamide hydrogel (Bulkamid) in treating stress urinary incontinence in women that have undergone radiotherapy to the pelvic region.

Researchers concluded that polyacrylamide hydrogel injections were safe and effective for the treatment of severe incontinence, regardless of previous radiotherapy to the region.

Vaginal sling procedures are currently the most common type of surgery used to help control stress urinary incontinence. However, there is evidence to suggest that vaginal sling procedures fail to restore continence among women that have previously undergone radiotherapy to the pelvic region.

Polyacrylamide hydrogel (Bulkamid) has recently been put forward as an alternative treatment option for stress urinary incontinence. Polyacrylamide hydrogel is injected directly around the urethra (the urine tract), causing it to narrow and prevent involuntary urine leakage. The efficiency of polyacrylamide hydrogel among patients that have previously undergone radiotherapy to the pelvic region has not been fully studied. 

A total of 46 women with severe stress urinary incontinence were included in this study. Of these, 24 women had previously undergone radiotherapy to the pelvic region (on average 8 years before the study). All women received treatment with a polyacrylamide hydrogel injection. Treatment outcome was compared between women that previously received radiotherapy to the pelvic region and those that did not.

Significantly reduced urinary incontinence was observed in all women, regardless of whether they had previously received radiotherapy to the pelvic region. Self-reported urinary symptoms, amount of urine leaked per day, and bladder emptying, were all improved among women receiving hydrogel injection treatment. Full continence (no urine leakage) was achieved in 25% of women that had undergone radiotherapy to the pelvic region, and in 36% of women that had not.

No differences were noted between the two groups regarding side-effects such as urinary tract infections or urinary urgency (reported in less than 7% of women undergoing treatment). 

Researchers concluded that polyacrylamide hydrogel injections are safe and effective in treating severe stress urinary incontinence, even among patients with incontinence due to previous pelvic radiotherapy.

Larger randomized trials examining the long-term effectiveness of polyacrylamide hydrogel injections are needed to confirm these preliminary results.