Periurethral Injection of Polyacrylamide Hydrogel for the Treatment of Stress Urinary Incontinence: The Impact on Female Sexual Function


Umberto Leone Roberti Maggiore, MD, Department of Obstetrics and Gynecology, San Martino Hospital and National Institute for Cancer Research, University of Genoa, Largo R. Benzi 1, 16132 Genoa, Italy. Tel: 00393289461340; Fax: 01139 010511525; E-mail:


Introduction.  Urinary incontinence can negatively affect sexual function.

Aim.  To investigate sexual function in female patients treated for urodynamic stress incontinence (USI) by periurethral injections.

Methods.  This double-center prospective study included 29 female patients who were treated for USI by periurethral injections of polyacrylamide hydrogel (Bulkamid®; Ethicon Women's Health and Urology, Contura, Denmark).

Main Outcome Measures.  Patients answered the International Consultation on Incontinence Questionnaire short form, the Incontinence Impact Questionnaire, and the Patient Global Improvement Impression. The Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 (PISQ-12) was used to evaluate sexual function at baseline and at 1-year follow-up. Patients were also asked to rate their sexual activity by using a 10-mm visual analog scale at baseline and at 12-month follow-up. Subjective and objective success was examined.

Results.  All patients were discharged on the same day of treatment and there was no intraoperative complication. At 1-year follow-up, the subjective success rate was 89.7% and the objective success rate was 79.3%. At 1 year from the first treatment, all the 23 sexually active patients continued to have regular sexual life. Six women reestablished sexual activity after the treatment. The total PISQ-12 scores showed a significant improvement in quality of sexual life of patients who were sexually active before surgery.

Conclusions.  Periurethral injections of polyacrylamide hydrogel to treat USI are clinically effective and safe. These surgical procedures cause significant improvements in sexual function and sexual satisfaction of patients. Leone Roberti Maggiore U, Alessandri F, Medica M, Gabelli M, Venturini PL, and Ferrero S. Periurethral injection of polyacrylamide hydrogel for the treatment of stress urinary incontinence: The impact on female sexual function. J Sex Med 2012;9:3255–3263.