Fellowship-Trained Urogynecologist
Urogynecology & Reconstructive Pelvic Surgery
Green Bay, Wisconsin
✓ Medically reviewed March 2026
Urethral Bulking for Stress Urinary Incontinence
Urethral bulking is a minimally invasive procedure used to treat stress urinary incontinence (SUI) in women. I use Bulkamid®, a modern urethral bulking agent with strong data behind it.
What is Bulkamid®?
Bulkamid® is a soft hydrogel consisting of 97.5% water and 2.5% polyacrylamide. This composition makes it:
- Biocompatible
- Non-degradable
- Tissue-friendly
I use Bulkamid® exclusively because it has better longevity and a lower complication rate than older bulking agents.
How urethral bulking works
The procedure involves:
- Injecting small amounts of Bulkamid® around the urethra
- Creating additional bulk to help the urethra close more effectively
- Improving urinary control during activities that increase abdominal pressure such as exercise, laughing, coughing, and sneezing
The Bulkamid® procedure
- Performed under local anesthesia in the office
- Takes about 10-15 minutes
- Typically involves 4 small injections
- Most patients are back to their normal routine within a day
Benefits of Bulkamid®
- Studies show short-term cure or improvement rates of 30-90%, depending on the study and how outcomes are measured
- Minimally invasive with quick recovery
- 7-year follow-up data shows about two-thirds of women maintain improvement or cure
- Can be repeated if necessary
- Preserves future treatment options
Who is a good candidate for Bulkamid®?
Bulkamid® may be a good option if you:
- Have stress urinary incontinence
- Want a minimally invasive, in-office procedure
- Prefer a quick recovery with minimal downtime
- Want to preserve other treatment options for the future
Recovery and results
- Most women return to normal activities within 24 hours
- Improvements are often noticed right away
- Full effects may be seen within a few weeks
Potential side effects
Some potential side effects include:
- Temporary discomfort or burning sensation when urinating
- Difficulty urinating
- Mild bruising or swelling
- Urinary tract infection (rare)
These effects are typically mild and short-lived.
Why Bulkamid® over older bulking agents?
Older bulking agents had issues with migration and reabsorption over time. Bulkamid® is a polyacrylamide hydrogel that stays where it’s placed, integrates well with surrounding tissue, and can be “topped up” if needed down the road. Seven-year follow-up data shows about two-thirds of women maintain their improvement or cure.
If you have stress urinary incontinence and want to talk about whether Bulkamid® makes sense for you, I’m happy to walk you through the options.
References
- Lose G, Sørensen HC, Axelsen SM, Falconer C, Lobodasch K, Safwat T. An open multicenter study of polyacrylamide hydrogel (Bulkamid®) for female stress and mixed urinary incontinence. Int Urogynecol J. 2010;21(12):1471-1477. doi:10.1007/s00192-010-1220-x
- Brosche T, Kuhn A, Gygax B, Hagmann B, Raio L. Seven-year efficacy and safety outcomes of Bulkamid for the treatment of stress urinary incontinence. Neurourol Urodyn. 2021;40(1):502-508. doi:10.1002/nau.24589
- Kasi AD, Pergialiotis V, Perrea DN, Khunda A, Doumouchtsis SK. Polyacrylamide hydrogel (Bulkamid®) for stress urinary incontinence in women: a systematic review of the literature. Int Urogynecol J. 2016;27(3):367-375. doi:10.1007/s00192-015-2781-y