What is urethral bulking therapy used for incontinence?

• A. Injectable bulking agents around the urethra (e.g., dextranomer/hyaluronic acid) to improve coaptation.
• B. Surgical removal of the urethral sphincter.
• C. Radiation therapy of bladder.
• D. Oral medications to tighten the urethra.

Answer: (A)

Urethral bulking therapy works by placing injectable materials around the urethra to bulk up the tissue and create a tighter seal, improving coaptation of the urethral walls during increases in abdominal pressure. This increases the outlet resistance of the urethra, helping to prevent leakage in stress urinary incontinence, especially when the problem is intrinsic sphincter deficiency. A common agent is dextranomer/hyaluronic acid, used to achieve this bulking effect. The procedure is minimally invasive and often performed in an office or minor procedure setting, with results that may require repeat injections for longer-term durability. It is not about removing the urethral sphincter, nor about radiation therapy, nor about taking oral medications to tighten the urethra.