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Midurethral sling

A bulking agent is a medical substance which can be injected into the outside edges of your urethra to help strengthen it. Bulking agents are usually synthetic (made of a manufactured medical substance) but sometimes collagen from cows is used. Bulking agents help the urethra stand up to pressure and prevent urine unexpectedly leaking when under pressure from an action such as a sneeze.

Bulking agents are an option if you are unable, or do not wish, to have other surgical treatments, or if you need, or wish, to postpone having surgery. Bulking agents are not a permanent solution and cannot cure stress incontinence because the bulking agent gradually and harmlessly dissolves over time, so the benefit is short-term.

During the operation, a surgeon uses a narrow, flexible, surgical telescope (called an endoscope) to insert a needle into, or next to, the wall of the urethra. Once inside, bulking agent is injected into the outside edges of the urethra. There are no incisions or stitches involved with this procedure.

Fig. 1: Bulking agents are injected into the urethral wall.
During and after bulking agent surgery