title: Polyacrylamide hydrogel (bulkamid®) in female patients of 80 or more years with urinary incontinence.
abstract: BACKGROUND
  To assess the effectiveness of polyacrylamide hydrogel (Bulkamid®) in injection therapy for urinary incontinence in women of 80 or more years.
  
  
  METHODS
  Twenty consecutive women mean age 84.5 (range 80-87) with stress or mixed urinary incontinence were enrolled in this prospective study. All subjects were evaluated at baseline and re-evaluated 7 days, 6,12,18 and 24 months after treatment. A detailed clinical evaluation, physical examination, daily pad count, urodynamic investigation and evaluation of urethral mobility by trans-labial ultrasound were performed.
  
  
  RESULTS
  A statistically significant decrease in the number of pads was observed in the follow-up (p = 0.0002 after 24 months). Physical examination showed a statistically significant lack or reduced lost of urine with stress test (p = 0.0163 after 24 months). Urodynamic findings showed an increase of Valsalva leak point pressure, maximum urethral closure pressure and functional length. Maximum flow and post void residual were respectively observed to be significantly reduced and increased only after 7 days from injection therapy. Quality of life (QoL) assessed with the Incontinence Impact questionnaire short form (IIQ-7) showed a statistically significant improvement (p = 0.0001 after 24 months). Patient satisfaction assessed with the Visual Analogue Scale and Patient Global Impression of Improvement questionnaire respectively produced evaluation of ″satisfied″ and "much improved" even after 24 months.
  
  
  CONCLUSIONS
  Polyacrylamide hydrogel (Bulkamid®) is an effective treatment with low morbility in patients of 80 or more years.
authors.affiliation: Division of Urology, ASUR, Area Vasta nº 2, Jesi, Italy.
authors.forename: Carlo Vecchioli-Scaldazza
authors.initials: CV
authors.lastname: Vecchioli-Scaldazza
authors.affiliation: Division of Urology, ASUR, Area Vasta nº 2, Jesi, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Smaali
authors.affiliation: Clinical Pathology, ASUR, Area Vasta nº 2, Jesi, Italy.
authors.forename: Carolina
authors.initials: C
authors.lastname: Morosetti
authors.affiliation: Division of Urology, ASUR, Area Vasta nº 2, Jesi, Italy.
authors.forename: Berouz
authors.initials: B
authors.lastname: Azizi
authors.affiliation: Division of Urology, ASUR, Area Vasta nº 2, Jesi, Italy.
authors.forename: Willy
authors.initials: W
authors.lastname: Giannubilo
authors.affiliation: Division of Urology, ASUR, Area Vasta nº 2, Jesi, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ferrara
mesh_terms: D000180:Acrylic Resins / Q000627:therapeutic use*; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D020100:Hydrogels / Q000627:therapeutic use*; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000188:drug therapy*; D014563:Urodynamics / Q000187:drug effects; D064232:Visual Analog Scale
chemical_list: D000180:Acrylic Resins; C528271:Bulkamid; D020100:Hydrogels; C016680:polyacrylamide gels