Urethral bulking agent found in a urethral caruncle which did not respond to topical oestrogens: A case report

Savvas, Christopher; Araklitis, George; Shah, Chirag; Robinson, Dudley; Cardozo, Linda

doi:10.1016/j.crwh.2020.e00268

Cited by 1 publication

(5 citation statements)

References 15 publications

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Section: Resultsmentioning

confidence: 99%

“…Non-migration of an agent is important as migration in one specific case report (for Macroplastique) led to scarring and caruncle formation. 21 No reports were found to suggest migration of material for Bulkamid, Coaptite, Contigen, Deflux, Urolastic and Zuidex. With regards to the manufacturer findings, Bulkamid is non-migratory, non-immunogenic, non-carcinogenic, non-inflammatory and inert as manufacturers have explicitly stated ‘no long-term complications reported’.…”

Section: Discussionmentioning

confidence: 99%

“…16 In addition, it has also been hypothesised that the heavy ‘bulk’ of these bulking agents may cause migration leading to adverse symptoms if injected incorrectly. 21 Build-up of this bulk could be due to incorrect injection technique (not directly in the mucosa) and reinjection.…”

Section: Discussionmentioning

confidence: 99%

“…20 Another case report documented symptoms of Macroplastique 1 year post-injection therapy as vaginal spotting, due to formation of a urethral caruncle, histology of this caruncle showed foreign material (Macroplastique) being engulfed by multinucleate giant cells to eventually form scarring. 21 Urolastic which is also made up of polydimethylsiloxane gel (like Macroplastique) is suggested to be superior to Macroplastique as it polymerises once injected. The biocompatibility of the agent allows it to adapt to the shape of its environment making it less prone to migration.…”

Section: Isolated Case Reports and Reviews Of Long-term Complicationsmentioning

confidence: 99%

“…Coaptite, Macroplastique and Urolastic have been reported to form erosions. 17 Macroplastique has also been known to cause caruncle formation 21 and calcifications. 19 Urolastic has also been reported to cause pain.…”

Section: Non-inflammatorymentioning

confidence: 99%

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Long-term complications of bulking agents in the treatment of stress urinary incontinence: Results of a national survey

Patel

Lazarowicz

Hamm

2022

Journal of Clinical Urology

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Introduction and Objectives: Bulking agents have been used for decades as an alternative treatment for patients with stress urinary incontinence who are not appropriate for surgery. Despite this their long-term complications are poorly documented and can be misdiagnosed. This paper presents a literature review and the results of a national survey of members of the Section of Female, Neurological and Urodynamic Urology (FNUU) of the British Association of Urological Surgeons (BAUS) identifying the common long-term complications of widely used bulking agents in clinical practice. Methods: Following a comprehensive literature review an electronic survey was sent to members of the BAUS Section of FNUU. Data included hospital trust, use of urethral bulking agents (including type), the approximate number of procedures performed and whether any long-term complications had been observed and managed in their practice. Long-term complications were defined as those arising more than 12 months after treatment. Results: The literature review revealed multiple case reports of complications secondary to bulking agent injection but no high-level evidence regarding frequency or severity. The survey revealed complications including granulomas, erosions, abscesses and misdiagnoses of urethral diverticula and calculi formation. 88% of urologists who responded to the survey had performed a urethral bulking agent injection and 51% of urologists had observed or treated a long-term complication, some many decades after injection. Conclusion: Patients should be made aware of possible long-term complications of what appears to be a minimally invasive procedure in order for them to make an informed choice about treatment options. Level of evidence: Not applicable

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%