How to stop leaking urine

28th April 2022 By Phoenix Hospital Group

In this article, Mr Keng Ng (Consultant Urologist, specialising in female urinary incontinence) answers commonly asked questions about treatments for stress incontinence, a condition which involves leaking urine when coughing or walking.

What causes leaking urine?

Stress incontinence is a condition whereby small amounts of leaking urine  from the bladder during certain physical activities, such as jumping, sneezing or exercising. Stress incontinence occurs when the sphincter, the small ring of muscle at the bottom of the bladder, becomes weakened.

Stress incontinence is fairly common, and the main causes include:

  • Childbirth
  • Weight gain
  • Age

Many women find that they leak urine when they cough, sneeze, walk fast, stand up from sitting, or exercise. As a result, they often have to wear incontinence pads or avoid going to the gym. It can therefore have a considerably large impact on their daily life and be uncomfortable and embarrassing.


What are the best treatment options for leaking urine?

Since the 1990s, the main form of treatment for urine leakage was the insertion of vaginal mesh implants known as TVT mesh slings. However, after a number of high profile lawsuits and controversies related to complications caused by erosion of the mesh, these have now been banned in many countries and are only now used in the UK in exceptional circumstances.

One option for treatment is colposuspension, which is a surgical procedure in which the neck of the bladder is lifted and held in place with stitches. This tends to be done as open surgery, however can also be performed as a keyhole procedure. As it is a surgical procedure, this does involve a small risk of complications and side effects.

A non-surgical option involving no incisions is Bulkamid injections. Bulkamid is a bulking agent in the form of a gel which is injected into the wall of the urethra above the sphincter to support its function and prevent leakage.


How does Bulkamid work?

The sphincter is a powerful ring of muscle located halfway along the length of the urethra.  If working as it should, the sphincter tightens to hold in urine whenever we cough, jump or sneeze. A weakened sphincter is unable to properly tighten. Therefore, Bulkamid gel is injected in 4 spots like a ‘ring of pearls’ just above the sphincter, which roll together to form an extra layer over the sphincter whenever you cough or sneeze. This provides additional support to the weakened sphincter, preventing urine from leaking out of the bladder.


How is the Bulkamid procedure performed?

Bulkamid injections tend to be performed under local anaesthetic and no aftercare is required. However, it can be performed under general anaesthetic if you would prefer. It produces immediate results and, unlike in the case of more invasive treatments, there is very little recovery time.

The procedure is over very quickly, taking only 5-10 minutes. When performed under local anaesthetic, you may resume normal activity immediately after the procedure, and can drive home or take public transport. You will be able to experience the benefits of Bulkamid immediately after the injections take place.


How effective is Bulkamid at preventing leaking urine?

Bulkamid has a success rate of over 80%, and this goes up to over 90% with a top up injection. It should last for life, and if some leakage does return as a result of changes to the body or particularly vigorous exercise, a top up injection should sort this out.


Where can I get Bulkamid treatment?

I carry out Bulkamid procedures at 9 Harley Street, where I run regular clinics. I am a Consultant Urologist who specialises in female urinary incontinence and have been performing Bulkamid injections since February 2009. I helped pioneer the 4-cushion method and have been a national and international trainer, holding masterclasses teaching other consultants the precise technique needed to produce the best results.

Find out more information here.

You can book a consultation with Mr Ng by calling 0207 079 2100 or email