A new treatment to cure urinary stress incontinence

Written by: Mr Keng Jin Ng
Published: | Updated: 19/02/2020
Edited by: Laura Burgess

There is now a new technique of using a special gel injected at the base of the bladder, essentially creating an extra ring of sphincter to help prevent stress incontinence, and provide a welcomed relief to those who struggle with bladder control.

The new gel is called Bulkamid. It is the special quality of the gel and the unique technique of placing the gel that makes the operation particularly successful. There has been a massive increase in the use of the Bulkamid gel in the United Kingdom over the past two years. It may well emerge as the new gold standard for urinary stress incontinence.

How does Bulkamid work?
These cushions of gel, forming like a ring of pearls, would roll down the top part of the water passage (urethra) during coughing or sneezing or whenever there is abdominal straining, and would in turn tightly squeeze against each other, essentially closing off the top part of the urethra during physical stress. Therefore, it is like adding an extra ring of gel sphincter above the natural sphincter muscle.
  

What happens during surgery with Bulkamid?
The operation can be performed under a short general anaesthetic when the patient is asleep or under local anaesthetic using a special numbing medicine for the urethra with the patient fully awake during the operation.

The gel injection takes about 15 to 20 minutes to perform. The patient may then go home the same day following the procedure with no specific after-care needed. The particular advantage of the gel injection is the lack of side-effects and complications.

The procedure can be repeated for the small number of patients who may require top-up injection for a tighter gel sphincter to accommodate more strenuous physical activity, or for those few patients where one of the gel cushions may have shrivelled over time.
 

Success rate of Bulkamid in curing stress incontinence
With precise technique, a surgeon can achieve over 80% success rate to cure stress incontinence. Studies have also shown that such good results can be maintained over the years without significant loss of effectiveness.



Our expert urologist Mr KJ Ng is a national and international trainer for Bulkamid gel injection. He has organised masterclasses to teach other consultant colleagues in the new technique and offered certificates of attendance. His 4-cushion gel ring has been adopted as the standard technique for Bulkamid injection.

Mr Ng’s Bulkamid gel injection technique achieves a success rate of 82.4%.  The results were presented at the International Urogynaecological Association (IUGA) conference in Nice, France in 2015. 

For more information, watch a step-by-step instructional video on the Bulkamid injection technique for the treatment of female urinary incontinence

By Mr Keng Jin Ng
Urology

Mr Keng Jin Ng is a leading consultant urological surgeon in London who specialises in female urology and minimally invasive surgery. He received his training at the Institute of Urology, London as a clinical research fellow where he focused his research on bladder dysfunction and urodynamics.

Mr Ng is the current chair of the specialist interest group International Urogynaecological Association on the subject of chronic pelvic pain and interstitial cystitis. He regularly holds surgical master classes for consultant colleagues and offers certificates of attendance.

Mr Ng is also a national and international trainer for Bulkamid bladder neck injection for urinary stress incontinence. He is a regular speaker at The London Bladder Forum to an audience of consultant colleagues speaking on topics such as cystitis, urinary incontinence and the treatment of bladder pain syndrome. 

He has been invited to present two lectures at the forthcoming annual conference of the International Urogynaecological Association (IUGA) from 2nd - 5th September 2020. The lectures are titled, "Urethral pain - from phenotyping to the concept of urethral colonisation/female prostatitis" and "Bulking agents in stress incontinence - a credible alternative".

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