Pai Aakash, Al-Singary Waleed
Worthing Hospital, Department of Urology, Worthing, United Kingdom.
Cent European J Urol. 2015;68(4):428-33. doi: 10.5173/ceju.2015.647. Epub 2015 Nov 13.
There are a myriad of treatment options available for patients suffering with the increasingly prevalent condition of stress urinary incontinence (SUI). The minimally invasive nature of periurethral bulking agents makes them an attractive proposition in the correctly selected patient. There is, however, limited data available on the medium to long term safety and efficacy of this procedure. The aim of our study is to evaluate the outcomes of Polyacrylamide Hydrogel (PAHG) (Bulkamid(®)) as a periurethral bulking agent at our institution.
From 2006 to 2011, two hundred and fifty six women underwent periurethral bulking with PAHG in the management of SUI or mixed urinary incontinence (MUI). Women were assessed with at least yearly quality of life and ICIQ questionnaires.
The majority of patients had the procedure under a local anaesthetic, with a median operative time of 9 minutes. Median follow up was 38 months. 82% of patients reported cure/significant improvement at 3 months. Importantly, this high satisfaction rate was maintained at final follow up and was reflected in both VAS and ICIQ scores. There were no reported adverse reactions and no significant safety concerns.
We conclude that Bulkamid(®) injection is an efficacious, minimally invasive, and safe procedure for a selected group of patients with stress incontinence. In our study, PAHG has been shown to be durable and safe.
对于患有日益普遍的压力性尿失禁（SUI）的患者，有无数种治疗选择。尿道周围填充剂的微创性质使其在正确选择的患者中成为一个有吸引力的选择。然而，关于该手术中长期安全性和有效性的数据有限。我们研究的目的是评估聚丙烯酰胺水凝胶（PAHG）（Bulkamid®）作为我院尿道周围填充剂的治疗效果。
2006年至2011年，256名女性接受了PAHG尿道周围填充术以治疗SUI或混合性尿失禁（MUI）。至少每年用生活质量和ICIQ问卷对女性进行评估。
大多数患者在局部麻醉下进行手术，中位手术时间为9分钟。中位随访时间为38个月。82%的患者在3个月时报告治愈/显著改善。重要的是，在最终随访时保持了这种高满意度，这在视觉模拟评分（VAS）和ICIQ评分中均有体现。没有报告不良反应，也没有重大安全问题。
我们得出结论，对于选定的压力性尿失禁患者群体，Bulkamid®注射是一种有效、微创且安全的手术。在我们的研究中，PAHG已被证明是持久且安全的。
