Bulkamid injections for stress urinary incontinence: how do they work?

Written by: Mr Keng Jin Ng
Published: | Updated: 21/09/2023
Edited by: Cameron Gibson-Watt

Stress urinary incontinence is a common condition among women, especially as they get older. Childbirth, obesity and pelvic floor disorders can weaken your pelvic floor muscles, stopping your urethra from closing properly and allowing urine to leak out during the day.

Thankfully, a new procedure known as Bulkamid is now available to treat this and allow you to regain control of your life.

Mr Keng Jin Ng, a top consultant urological surgeon based in London, explains more about Bulkamid injections, how they work and who is suitable for the treatment.



How do Bulkamid injections work?

Bulkamid is a unique hydrogel that can be injected into the urethra (the tube that carries urine from the bladder out of the body) to treat stress urinary incontinence.


Using the hydrogel, the idea is to create cushions of the gel, like a “ring of pearls”, in the upper part of the urethra to work as an extra sphincter. This extra “ring of pearls” sphincter sits above the natural muscle sphincter to help prevent any leakage of urine.


How is Bulkamid injected?

Bulkamid can be injected using a syringe under local anaesthetic and with a special camera system. The procedure time is very short, taking around 5-10 minutes, and is done in an out-patient clinic. No incisions or cuts are made.


What is the recovery like receiving a Bulkamid injection?

Patients undergoing Bulkamid injections do not need any special post-operation care. They can resume normal daily activity immediately following the injection.


Who is suitable for Bulkamid injections?

The Bulkamid injection treatment is suitable for all adult women of any age who suffer from stress incontinence. Typically, these patients suffer from leakage of urine on coughing or sneezing, or when getting up from a seated position. The cause of such urine leakage is due to the weakness of the natural muscle sphincter of the urethra.


How successful are Bulkamid injections?

In experienced hands, expert surgeons achieve over 80% success rate in treating stress urinary incontinence with just one session of injection.


When audited by a team of specialist urology registrars from the Imperial College London training scheme, Mr Ng's personal success rate with Bulkamid injection was rated at 82%.


As the Bulkamid gel is designed to work permanently, the success of surgery is well maintained for at least seven years. Over time, if the natural muscle sphincter were to weaken further, a top-up injection of Bulkamid should easily restore continence.


Furthermore, top-up injections can be offered for those who need even better results, especially for those who are involved in strenuous exercise and sports. 



Mr Keng Jin Ng has been a national and international trainer for Bulkamid injection since 2014 and has held masterclasses teaching other consultant surgeons the optimal technique for the injection procedure.


If you are interested in receiving a Bulkamid injection from Mr Keng Ng, head to his Top Doctors profile to book an appointment with him.

By Mr Keng Jin Ng

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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