Name of the Procedure:

Injectable Bulking Agent, Dextranomer/Hyaluronic Acid Copolymer Implant, Urinary Tract (L8604)

• Common name(s): Urethral Bulking Agent Injection
• Medical term: Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, urinary tract

Summary

This procedure involves injecting a gel-like substance into the urinary tract to help treat conditions like urinary incontinence. The injectable material is a combination of dextranomer and hyaluronic acid, which works to provide extra support to the tissues in the urinary tract.

Purpose

Medical Conditions:

• Stress urinary incontinence (SUI)
• Weakness or damage in the tissues supporting the urethra

Goals/Outcomes:

• Strengthen the tissues in the urinary tract
• Improve bladder control
• Reduce or eliminate episodes of urinary incontinence

Indications

Symptoms:

• Frequent accidental leakage of urine, especially during physical activities like coughing, sneezing, or exercising

Patient Criteria:

• Patients who have not responded well to conservative treatments like pelvic floor exercises or medications
• Patients seeking a minimally invasive option

Preparation

Pre-procedure Instructions:

• Patients may be advised to stop taking certain medications like blood thinners
• Fasting may be required if sedation or anesthesia will be used

Diagnostic Tests:

• Urinalysis to rule out infections
• Urodynamic studies to assess bladder function

Procedure Description

1. Prepping: The patient is positioned appropriately, and the urinary tract area is cleaned and prepped.
2. Anesthesia: Local anesthesia is usually administered to numb the area.
3. Injection: Using a cystoscope (a thin tube with a camera), the doctor injects the bulking agent into the tissue surrounding the urethra.
4. Completion: The cystoscope is removed, and the patient is monitored for a short period before discharge.

Tools/Equipment:

• Cystoscope
• Syringe with dextranomer/hyaluronic acid copolymer gel

Duration

The procedure typically takes about 30 minutes to an hour.

Setting

Performed in:

• Outpatient clinic
• Hospital setting
• Surgical center

Personnel

Healthcare professionals involved:

• Urologist or specialized physician
• Nurse
• Anesthesiologist (if sedation is used)

Risks and Complications

Common Risks:

• Mild pain at the injection site
• Temporary difficulty with urination

Rare Risks:

• Infection
• Allergic reaction to the bulking agent
• Urinary retention

Benefits

Expected Benefits:

• Significant reduction in urine leakage
• Improvement in quality of life

Timeline:

• Benefits can often be noticed within a few weeks after the procedure

Recovery

Post-procedure Care:

• Patients can usually go home the same day
• Avoid strenuous activities for a few days
• Drink plenty of water to help flush the bladder

Recovery Time:

• Most people can return to normal activities within a few days
• Follow-up appointments may be required to check on progress

Alternatives

Other Treatment Options:

• Pelvic floor exercises (Kegel exercises)
• Medications
• Surgical options like sling procedures

Pros and Cons of Alternatives:

• Exercises and medications are less invasive but might be less effective for some patients
• Surgical options are more invasive but may offer a more permanent solution

Patient Experience

During Procedure:

• Mild discomfort or pressure during the injection
• Minimal to moderate pain if local anesthesia is used

After Procedure:

• Temporary soreness in the treated area
• Instructions will be provided for pain management and comfort, like localized ice packs or prescribed pain relievers