Taking Control Of Stress Urinary Incontinence

Stress Urinary Incontinence (SUI) is a very common condition, affecting an estimated 30% of women worldwide. The condition can have a significant impact on daily life affecting activities, relationships and emotional well-being. Two-thirds of these women suffering from SUI are undiagnosed.

SUI is caused by a weakness in the pelvic floor, preventing the urethra from closing fully when sudden pressure is put on the bladder. This can allow urine to leak out during normal daily activities for example when coughing, laughing, walking or exercising.

A new survey commissioned by Contura International* showed that around 9 out of 10 women living with SUI are likely to simply “put up with” the condition, rather than seeking treatment and advice, despite many negative effects on their quality of life, relationships or ability to exercise.

In response to these findings, the campaign #controlyourchoice was recently launched, to empower women to seek minimally invasive treatment options for SUI – as well as helping to remove the stigma and ensure no woman is “suffering in silence.”

And, as part of the campaign, we spoke to three women who say treatment for SUI using Bulkamid, a urethral (or “bladder neck”) bulking agent has changed their lives, allowing them to run, climb and compete in confidence!

vicki williams

Vicki Williams, 44, is an ODP (Operating Department Practitioner) at York Hospital. Vicki (who has a 13-year-old son) underwent treatment for SUI, in October 2017. She says;

“Over the past few years, I’d really got into going to the gym, particularly working with weights but increasingly my bladder issues – and those embarrassing leaks – were really starting to impact on what I could comfortably do.

“Lifting heavier weights was becoming impossible – let alone more energetic forms of exercise such as jumping and skipping – so I decided enough was enough and I wanted to do something about it. I wasn’t prepared to give up my love of fitness and going to the gym regularly – nor did I want to be constantly worrying about wearing incontinence pads.

“In fact, it wasn’t just the gym where the problem was having an impact on my life – I was also struggling through the hay fever season, when I would often experience leaks due to sneezing.

“So, I booked an appointment with my GP and requested a referral for further investigation. It was then that my Consultant suggested bladder neck bulking with Bulkamid as an alternative to the surgical approaches available and to me it was an instant ‘no-brainer.’

“The procedure (which was carried out by the NHS at my local hospital in York) took around 15 minutes and although it was a little uncomfortable and stung a bit (when the local anaesthetic was applied) it was all over in 15 mins and I was able to go home shortly after. In fact, I was back at the gym that evening and achieved a ‘Personal Best’ in dead lifting (without any leakage!)”

“Since my treatment (and the fact I no longer need to use pads) lots of my friends and ‘gym buddies’ have asked me to tell them more about “what I’ve had done”. So, I hope that by becoming such an advocate of this type of treatment and being prepared to ‘shout about it from the rooftops’, more women like me will speak to their GP to discuss what options are open to them too.”

Bladder neck bulking with Bulkamid is making a dramatic difference to the quality of lives of women of all ages and generations.

Ann Wells

Ann Wells, 71 (who has two grown-up sons, and a 2-year old granddaughter) underwent a recent Bulkamid treatment for SUI in January 2018. She says;

“I’ve actually been treated for stress incontinence on two occasions and both times, the results have been absolutely remarkable!

“The first time that I was referred by my GP was around 5 years ago, having been suffering from embarrassing leaks for about 12 months prior.

“As a keen walker, enjoying regular holidays in the Lake District, I soon decided that stress incontinence wasn’t something that I was prepared to put up with. I’d tried pelvic floor exercises and specialist physiotherapy but neither seemed to make much difference. Yes, I was able to wear pads in the short term but increasingly, I found them uncomfortable and inconvenient and I was becoming rather fed up with outings and holidays constantly interrupted by my need of having to locate a loo!”

“Following my initial consultation, I was recommended Bulkamid as the most appropriate and least invasive option. I then only had to wait 3 months for the procedure, which was carried out, under the NHS, at the Royal Berkshire Hospital.

“I opted to have a General Anaesthetic (although I understand some women have had the procedure with just a Local Anaesthetic) and my entire visit from start to finish took 5 hours. As I was informed, the procedure itself is “non-invasive” and takes around 15 minutes! Certainly, I was back doing all my normal activities the next day – which seems incredible given the usual 6-week recovery time from traditional surgery!

“From that day onwards, I didn’t need to wear pads again and those embarrassing leaks when coughing, sneezing, walking up a hill were a thing of a past. It made such a difference to my life. However, at the time of my first procedure, I was advised that there was a slight chance that I might need a repeat procedure or “top up” within a few years. So, when I became aware of a few little leaks again (when coughing) I didn’t think twice about asking for another referral.

“Once again, the results have been “remarkable”. I am now able to enjoy an active, ‘leak-free’ retirement and can play with and scoop up my little grand-daughter without worrying about an embarrassing accident! I would have no hesitation in recommending that other women speak to their GP and consider bladder neck bulking as a treatment option.”

Contura’s same survey also showed that four in 10 (39%) women admitted they avoid certain activities (such as bouncing on a trampoline with their children, wearing certain clothes or attending an exercise class), for fear of accidental bladder leakage, rising to 52% of women aged 35-44

Natalie Poole

However, keen runner and mum of 2, Natalie Poole wasn’t prepared to let SUI stop her in her tracks.

Natalie (40), who works as a Maternity Assistant at Worthing Hospital, underwent Bulkamid treatment for SUI in January 2018. She says;

“As my 40th birthday drew closer I decided to join a running club – for both fitness and social reasons – and I really loved it. But not long after, I noticed I was becoming damp whilst running and, on some occasions, quite wet. I mentioned it to a few of the other ladies I was running with and was surprised that many of them were also experiencing similar problems – but were just resigned to wearing pads on a daily basis.”

“However, that was just something I was not prepared to do. I did not want that to become the new normal for me.”

“So, I booked an appointment with my GP – a fantastic female GP who was so sympathetic and proactive. I remember her words to me were, ‘let’s get this sorted now’ and she quickly referred my local hospital for bladder neck bulking treatment.”

“My urologist talked me through all the options available but we both agreed that the minimally invasive bladder neck bulking procedure with Bulkamid was the best treatment for me.”

“The treatment took around 15 minutes. The team were lovely, so reassuring and I honestly didn’t experience any discomfort, apart from some slight tingling as the gel was applied. I was back home later that day and returned to normal family life and activities straight away. I can’t thank my consultant and his team enough!”

“Since my treatment, I haven’t looked back. I haven’t experienced another leak and I’d go as far as to say it’s changed my life (certainly my life as a keen runner!). Now, I’m really spreading the word about my positive experience amongst those of my friends who might otherwise have carried on “suffering in silence”. I already know of at least one lady who has since been referred for Bulkamid treatment since I started talking about it!”

“I consider myself lucky to have such an understanding husband who I can talk to about “embarrassing” issues and such a knowledgeable and progressive GP!”

“In my job, I look after lots of ladies who will, of course, receive advice from their midwives about pelvic floor exercises following the birth of their babies which are of course really important. But I also hope that if they ever start experiencing leaks when sneezing, running or bouncing on a trampoline with their toddlers they won’t feel at all embarrassed about asking for help.”

“There should be no stigma around SUI!”

Bulking agents are a minimally invasive (meaning no cutting of the patient’s tissue or skin), safe and effective treatment for stress urinary incontinence which have been used for over 10 years.

By far the most widely used bulking agent in the UK is Bulkamid® (essentially a water-based soft gel that helps the bladder neck to close when needed to help prevent bladder leaks). Bulkamid has a 70% – 80% success rate1,2,3 when used as a first-line treatment and to date has treated over 50,000 women. A European multi-centre study with 135 women found an 89% reduction in leakage and an 83% reduction in incontinence episodes at the two year follow up endpoint of the study4. The bio-compatible soft gel remains in place and continues to work for many years, as has been shown by UK (5 year)1 and German (7 year)2 studies.

For more information about bladder neck bulking treatment or to find a hospital near you where the procedure is carried, please go to the website.

* Fieldwork for the survey took place 1st – 4th December 2017, among 2,000 women, aged 18+

  1. Pai A, Al-Singary W. Cent European J Urol. 2015;68(4):428-33
  2. Lobodasch K & Brosche V. Long-term effectiveness and durability of Bulkamid® as primary treatment of stress urinary incontinence – a longitudinal study. ICS 2015 abstract
  3. Andrews V et al. Bulkamid® – does the volume injected affect outcome? IUGA 2015
  4. Toozs-Hobson P et al Int. Urogynecol J, 2012 Oct (10):1373-8.