Injection Treatments for Urinary Incontinence

What are the Injection Treatments for Urinary Incontinence

Urinary incontinence is a condition in which a person cannot control when he or she passes urine. The muscle that normally keeps urine from leaking (urinary sphincter) may be weak. To treat this condition, a material (bulking agent) can be injected either into the area of the body that drains urine (urethra) or near where the bladder and urethra connect (bladder neck). This is called an implant. The implant narrows and strengthens the urethra to help control passage of urine.

Urinary incontinence is a common problem for women who have had pregnancies or surgery such as a hysterectomy, and for men who have had prostate surgery.

Tell a health care provider about:

  • Any allergies you have.
  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems you or family members have had with anesthetic medicines.
  • Any blood disorders you have.
  • Any surgeries you have had.
  • Any medical conditions you have.
  • Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Infection.
  • Bleeding.
  • Allergic reaction to medicines or to the bulking agent.
  • Damage to the urethra or bladder.
  • Difficulty passing urine.
  • A strong and uncomfortable urge to pass urine (urgency).
  • Pain when passing urine or having sex.
  • Failure of the procedure to improve incontinence.
  • A need to repeat the procedure at a later time.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

  • Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

  • 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
  • 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
  • 6 hours before the procedure – stop drinking milk or drinks that contain milk.
  • 2 hours before the procedure – stop drinking clear liquids.

Medicines

  • Ask your health care provider about:
    • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
    • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
    • Taking over-the-counter medicines, vitamins, herbs, and supplements.

General instructions

  • Ask your health care provider what steps will be taken to help prevent infection. These may include:
    • Removing hair at the surgery site.
    • Washing skin with a germ-killing soap.
    • Antibiotic medicine.
  • You may need to have a series of tests done to learn more about your bladder control (urodynamic testing).
  • Plan to have someone take you home from the hospital or clinic.
  • Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.

What happens during the procedure?

  • An IV may be inserted into one of your veins.
  • You may be given one or more of the following:
    • A medicine to help you relax (sedative).
    • A medicine to numb your urethra and bladder area (local anesthetic).
    • A medicine to make you fall asleep (general anesthetic).
  • A small, thin tube (catheter) may be inserted through your urethra into your bladder.
  • A long, thin tube with a light and camera (cystoscope) will be placed into your urethra and moved up toward your bladder. The camera sends images to a screen in the room. These images will be used to help guide the procedure.
  • A long needle will be threaded through the cystoscope.
  • Bulking material will be injected into the tissues around your urethra, near your urinary sphincter.
  • The cystoscope and needle will be removed.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the hospital or clinic.
  • If you have a catheter in your urethra, it will be removed to see if you can pass urine. If you have trouble passing urine, a new catheter may be inserted and left in place for a few days.
  • Your bladder may be filled with fluid through your catheter to check for any problems in the bladder.
  • You may be given antibiotic medicine to take at home.
  • Do not drive for 24 hours if you were given a sedative.

Summary

  • Urinary incontinence is when you cannot control when you pass urine. The muscle that normally keeps urine from leaking (urinary sphincter) may be weak.
  • Urinary incontinence is a common problem for women who have had pregnancies or surgery such as a hysterectomy, and for men who have had prostate surgery.
  • To treat this condition, a material (bulking agent) can be injected either into the part of the body that drains urine from the bladder (urethra) or near where the bladder and urethra connect (bladder neck).

Care After Injection Treatments for Urinary Incontinence

Here is the information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After this procedure, it is common to have:

  • Trouble passing urine.
  • A small amount of blood in your urine.
  • A burning or stinging sensation when passing urine.
  • No improvement in your urinary incontinence for a few weeks.

Follow these instructions at home:

Catheter care

  • If you go home with a urinary catheter in place, care for your catheter as told by your health care provider. This may include:
    • Washing your hands before and after touching the catheter.
    • Keeping the area around the catheter clean and dry.
    • Making sure the catheter drainage bag is lower than your hips and bladder. This stops urine from going back into the tubing and into your bladder.
    • Emptying the catheter drainage bag when it is full and monitoring the amount and color of your urine.
    • Checking to make sure that there are no twists or bends (kinks) in the catheter tube.
    • Visiting your health care provider to have the catheter removed.

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

General instructions

  • Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
  • Drink enough fluid to keep your urine pale yellow.
  • Do not take baths, swim, or use a hot tub if you have a urinary catheter in place.
  • Do not drive for 24 hours if you were given a medicine to help you relax (sedative) during your procedure.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if you have:

  • Blood in your urine for longer than a few days.
  • Pain when passing urine that lasts for longer than a few days.
  • A strong and uncomfortable urge to pass urine (urgency).
  • Incontinence that does not improve after a few weeks.

Get help right away if you:

  • Have a fever.
  • Cannot urinate.
  • Have cloudy or bad-smelling urine.
  • Have pain when passing urine, and the pain is getting worse.
  • Have a lot of blood in your urine.

Summary

  • After this procedure, it is common to have trouble passing urine and to have a small amount of blood in the urine.
  • Your incontinence should improve in a few weeks.
  • If you go home with a urinary catheter in place, care for your catheter as told by your health care provider.
  • Return to your normal activities as told by your health care provider.
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