Periurethral injection of polyacrylamide hydrogel for the treatment of stress urinary incontinence: the impact on female sexual function

Abstract

Introduction: Urinary incontinence can negatively affect sexual function.

Aim: To investigate sexual function in female patients treated for urodynamic stress incontinence (USI) by periurethral injections.

Methods: This double-center prospective study included 29 female patients who were treated for USI by periurethral injections of polyacrylamide hydrogel (Bulkamid(®); Ethicon Women's Health and Urology, Contura, Denmark).

Main outcome measures: Patients answered the International Consultation on Incontinence Questionnaire short form, the Incontinence Impact Questionnaire, and the Patient Global Improvement Impression. The Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 (PISQ-12) was used to evaluate sexual function at baseline and at 1-year follow-up. Patients were also asked to rate their sexual activity by using a 10-mm visual analog scale at baseline and at 12-month follow-up. Subjective and objective success was examined.

Results: All patients were discharged on the same day of treatment and there was no intraoperative complication. At 1-year follow-up, the subjective success rate was 89.7% and the objective success rate was 79.3%. At 1 year from the first treatment, all the 23 sexually active patients continued to have regular sexual life. Six women reestablished sexual activity after the treatment. The total PISQ-12 scores showed a significant improvement in quality of sexual life of patients who were sexually active before surgery.

Conclusions: Periurethral injections of polyacrylamide hydrogel to treat USI are clinically effective and safe. These surgical procedures cause significant improvements in sexual function and sexual satisfaction of patients.