Postprostatectomy incontinence (PPI) is a potential complication of radical prostatectomy. Although most men recover from PPI, some men continue to have persistent urinary incontinence. Treatment of small volume persistent PPI with male sling or an artificial urinary sphincter may be overly invasive and the concept of intraurethral injection is very appealing in this situation. Bulkamid is a non-particulate polyacrylamide and water polymer gel, which is being used successfully in female stress urinary incontinence. We have assessed the feasibility and effects of a 4 point intra-urethral technique on maximum urethral closing pressure (MUCP) in male cadavers.

Urethral pressure profile (UPP) was measured twice on 2 male fresh frozen cadaver models before and after a 4 point injection of 2mls of Bulkamid intraurethrally at sphincteric level in 0.5ml aliquots using a 7Fr flexible needle (Olympus 00126).

A clear UPP trace was recordable in both cadavers. The mean MUCP at baseline was 38 cm H2O and the mean MUCP following Bulkamid intraurethral injection was significantly increased to 51.25 cm H2O. (P<0.05)

Bulkamid intraurethral injection in male cadavers is a simple technique, which significantly increases MUCP.

This raised MUCP may allow for treatment of PPI and warrants further study in this clinical situation.