Periurethral abscess following polyacrylamide hydrogel (Bulkamid) for stress urinary incontinence

Int Urogynecol J. 2012 Nov;23(11):1645-8. doi: 10.1007/s00192-012-1768-1. Epub 2012 Apr 18.

Abstract

Bulkamid is a periurethral bulking agent used to treat stress urinary incontinence (SUI). Manufacturers describe it as nontoxic, nonbiodegradable and biocompatible. Periurethral abscesses are one of the known complications of bulking agents. We present the first reported case of periurethral abscess following Bulkamid injection. The woman had previously had a transobturator tape (TOT) and total vaginal mesh repair. At 6 weeks after injection of the bulking agent, she reported 100 % cure of her SUI. Transperineal ultrasound was used to diagnose and monitor an abscess that developed anterior and lateral to the urethra and separate from the TOT. Magnetic resonance imaging was helpful in delineating the extent of the abscess into the retropubic space but was not able to identify the urethra or the TOT. Surgical drainage of the abscess was performed vaginally, resulting in successful resolution of pain but recurrence of incontinence.

Publication types

  • Case Reports

MeSH terms

  • Abscess / chemically induced*
  • Abscess / pathology
  • Abscess / surgery
  • Acrylic Resins / administration & dosage
  • Acrylic Resins / adverse effects*
  • Acrylic Resins / therapeutic use*
  • Aged
  • Drainage / methods
  • Female
  • Gynecologic Surgical Procedures
  • Humans
  • Hydrogels / administration & dosage
  • Hydrogels / adverse effects*
  • Hydrogels / therapeutic use*
  • Injections
  • Magnetic Resonance Imaging
  • Recurrence
  • Treatment Outcome
  • Urethral Diseases / chemically induced*
  • Urethral Diseases / pathology
  • Urethral Diseases / surgery
  • Urinary Incontinence, Stress / drug therapy*
  • Urinary Incontinence, Stress / epidemiology

Substances

  • Acrylic Resins
  • Bulkamid
  • Hydrogels
  • polyacrylamide