What Is a Bulkamid Injection and How Does It Help Stress Incontinence?

If you’ve ever leaked urine when you laugh, cough, run, or even pick up a grocery bag, you are not alone. This is called stress urinary incontinence, and it’s something I hear about from women all the time in my practice. The good news is there is a newer treatment option for this condition called Bulkamid, and it has provided relief for many women.

Why does stress incontinence happen?

Think of your bladder like a balloon and your urethra (the tube urine comes out of) as the knot at the end. Normally, muscles and tissues around the urethra keep that knot tightly closed until you’re ready to go. But with stress incontinence, those supports are weaker. So when extra pressure hits, like a laugh, a sneeze, a workout, or even just bending over, urine can slip out.

This can happen for a lot of reasons:

• Pregnancy and childbirth
• Hormone changes around menopause (lower estrogen)
• Aging and loss of muscle tone
• Prior pelvic surgery
• Genetics and connective tissue strength

What are treatments for stress incontinence?

The good news: you’ve got options, and not all of them involve surgery.

• Lifestyle changes: things like weight loss, cutting back caffeine, or timing fluids can make a difference.
• Pelvic floor exercises (Kegels): strengthening the muscles that support the bladder. These often work best when guided by a pelvic floor physical therapist.
• Devices: small supports called pessaries can sit in the vagina and help reduce leakage.
• Procedures: if those steps aren’t enough, there are minimally invasive treatments and surgeries designed specifically to stop stress leaks such as Bulkamid or slings.

What is Bulkamid?

One option I often discuss with patients is Bulkamid. It’s a soft, water-based gel that gets injected into the urethral wall. Think of it like giving the urethra a little extra cushion so it can close better and keep urine in when it should.

Here’s why many women like Bulkamid:

• No incisions — it’s done through a tiny scope in the outpatient setting (typically with mild sedation).
• Quick recovery — most people are back to normal activity within a day.
• Lasting results — the gel doesn’t get absorbed by your body, so improvements can last years.
• Flexible — if you need a “touch-up” injection later, it’s easy to do.

What to expect during a Bulkamid injection

The procedure is pretty straightforward: A small camera is used to look into the urethra, then place the gel in a few spots. The whole thing usually takes less than 15 minutes. Most women notice improvement right away, though sometimes a second round of injections are needed to fine-tune the results.

How long does the Bulkamid injection last?

Bulkamid is a non-absorbable gel that is designed to last for years. Many women experience symptom improvement that lasts for seven years or more. However, sometimes a touch-up injection may be needed down the road if symptoms start to return.

What are the side effects of Bulkamid?

Bulkamid is considered safe, but like any medical procedure, there can be minor side effects. The most common include:

• Temporary burning or discomfort when urinating
• Mild spotting or blood in the urine for a day or two
• Feeling the need to urinate more often (typically short-lived)

Serious complications are rare, but as with any injection, there is a small risk of infection or urinary retention (trouble emptying the bladder). Infections are treated with antibiotics. Difficulty emptying the bladder can be treated with a temporary catheter for typically less than 24 hours.   

The bottom line

If you’re missing out on exercise or other activities, you don’t have to keep struggling. It does not have to be accepted as a “normal” part of life. Stress incontinence is common, but it’s treatable.

Bulkamid is one of several options available, and it can be a great choice if you want something minimally invasive with a quick recovery. While it isn’t the right choice for everyone, it has helped many patients regain confidence and quality of life.

If you’re curious, the best next step is to talk to a urologist or urogynecologist. Together, we can sort through your symptoms, lifestyle, and preferences to figure out whether Bulkamid(or another approach) is right for you.

Remember: You don’t have to “just deal with it.” There are real, safe and effective treatments that can help you laugh, sneeze, and exercise with confidence again.

Learn more about the author of this blog, urologist Elizabeth Peacock, MD