Hopeful image of woman finding relief from urinary incontinence through urethral bulking agents.

Failed Sling Surgery? Discover Urethral Bulking Agents as a Salvage Solution

Samir D’Costa in Health & Wellness December 2025 • 4 min read.

"A comprehensive look at how urethral bulking agents can offer relief for persistent stress urinary incontinence after failed sling procedures, providing a less invasive alternative with significant short-term benefits."

Stress urinary incontinence (SUI), characterized by the involuntary loss of urine during exertion or physical activity, affects millions of women worldwide. Traditional treatments, such as midurethral slings (MUS), have become the gold standard for surgical intervention. However, a significant percentage of these procedures fail, leaving women seeking alternative solutions.

When sling surgeries don't provide the expected relief, the impact on quality of life can be substantial. Many women face the difficult decision of undergoing repeat surgeries, which carry additional risks and recovery time. This has led to increased interest in less invasive options, particularly urethral bulking agents.

This article explores the use of urethral bulking agents as a salvage therapy for women experiencing persistent or recurrent SUI after a failed sling procedure. We will delve into a recent study that investigates the effectiveness of these agents in providing symptomatic relief and improving overall quality of life, offering a glimmer of hope for those seeking a less daunting path to continence.

Urethral Bulking Agents: A Second Chance for Continence?

Hopeful image of woman finding relief from urinary incontinence through urethral bulking agents.

Urethral bulking agents have emerged as a potential solution for women experiencing SUI after failed sling surgery. These agents are injected into the urethral wall to increase its thickness, providing greater support and resistance to involuntary urine leakage. This approach offers a less invasive alternative to repeat sling surgeries, making it an appealing option for many.

A recent retrospective study examined the outcomes of 73 women who underwent urethral bulking agent injections following a failed sling procedure. The results shed light on the potential benefits of this approach:

Symptomatic Relief: 71% of patients reported short-term improvement or resolution of symptoms following urethral bulking agent injections.
SUI-Specific Improvement: The improvement in SUI symptoms persisted for an average of 35 months in patients with available long-term data.
Validated Questionnaires: Statistically significant improvement persisted on the stress incontinence and quality of life domains of the validated questionnaires.

While not a permanent fix, urethral bulking agents can provide a significant window of relief, improving quality of life and reducing the need for more invasive interventions. It's important to note that the effectiveness may decrease over time, and repeat injections may be necessary to maintain the desired results.

A Viable Option for Improved Quality of Life

Urethral bulking agents offer a valuable alternative for women struggling with persistent or recurrent SUI after failed sling surgery. While the benefits may not be permanent, the short-term relief and improved quality of life can make a significant difference.

The procedure is performed in an office setting, minimizing the risks associated with more invasive surgical interventions and general anesthesia. This makes it an attractive option for women who wish to avoid secondary operative procedures.

If you're experiencing SUI after a failed sling procedure, discuss urethral bulking agents with your healthcare provider to determine if this approach is right for you. It could be the key to regaining control and enjoying a more active, fulfilling life.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.urology.2018.09.019, Alternate LINK

Title: Can Urethral Bulking Agents Salvage Failed Slings?

Subject: Urology

Journal: Urology

Publisher: Elsevier BV

Authors: Elizabeth V. Dray, Marybeth Hall, Diana Covalschi, Ann P. Cameron

Published: 2019-02-01

Everything You Need To Know

How do urethral bulking agents work to treat urinary incontinence?

Urethral bulking agents are injected into the urethral wall to increase its thickness. This added thickness provides greater support to the urethra, helping it to resist involuntary urine leakage that characterizes stress urinary incontinence (SUI). This method is less invasive than repeat sling surgeries, offering an appealing alternative for those who have experienced failure with the midurethral slings (MUS) procedure.

Why would someone consider urethral bulking agents after having a sling surgery?

While midurethral slings (MUS) are often the first choice for surgical treatment of stress urinary incontinence (SUI), a notable percentage of these procedures are unsuccessful. This can leave women seeking other options to manage their condition and improve their quality of life. Failed midurethral slings (MUS) leads to the consideration of alternative treatments like urethral bulking agents.

What kind of improvements can women expect after undergoing urethral bulking agent injections?

A recent study showed that 71% of patients reported short-term improvement or resolution of stress urinary incontinence (SUI) symptoms after receiving urethral bulking agent injections. The benefits can last for an average of 35 months. Patients also reported statistically significant improvements in their stress incontinence and overall quality of life, as measured by validated questionnaires.

Are urethral bulking agents a permanent fix for urinary incontinence after a failed sling procedure?

Urethral bulking agents are generally considered a short-term solution for stress urinary incontinence (SUI) following a failed midurethral slings (MUS) procedure. The effects of the bulking agents may diminish over time, and repeat injections may be necessary to maintain the desired level of continence. The durability depends on factors like the specific agent used and the individual's physiology.

Besides urethral bulking agents, what other treatment options are available for persistent stress urinary incontinence (SUI) after a failed midurethral slings (MUS) procedure?

While the focus is on urethral bulking agents, other options exist. These include conservative management, such as pelvic floor exercises, and other surgical options. The choice depends on the individual's overall health, the severity of their stress urinary incontinence (SUI), and their preferences. A comprehensive discussion with a urologist is essential to explore all available options and determine the most suitable approach.