Université de Rennes Injections péri-urétrales de Bulkamid en consultation et en ambulatoire : étude monocentrique rétrospective Outpatient periurethral injections of polyacrylamide hydrogel (BulkamidÒ) under local anesthesia in the office: a prospective single-center series incontinence urinaire à l'effortpersonnes âgéesinjection périurétraletraitementanesthésie localeambulatoire urinary incontinence, stresselderlyperiurethral injectiontreatmentlocal anesthesiaoutpatient Incontinence urinaire chez la femme‎ Incontinence urinaire d'effortChez la personne âgée Injections Sphincter urétral Anesthésie locale Soins médicaux ambulatoires Polyacrylamide hydrogel (BulkamidÒ) is a relatively recent bulking agent which may have a better safety profile than previous generations. The objective of this study was to report our experience of outpatient peri-urethral injections of Bulkamid under local anesthesia in the office in female patients for stress urinary incontinence (SUI). The data of all women who underwent outpatient peri-urethral Bulkamid injections under local anesthesia in the office at a single academic center were collected prospectively between November 2019 and August 2023. This therapeutic option was offered to patients who had SUI if > 80-year-old and/or had multiple comorbidities or if they declined all other therapeutic options. Ninety-two patients were included. The mean age was 78 years (30-97). Twenty patients experienced postoperative complications (21%), nineteen were Clavien 1 complication, only one complication was Clavien = 4. The USP SUI and OAB subscores and the ICIQ-SF were all significantly improved at 3 months (p<0.001). The VAS for urethral coaptation self-assessed by the surgeon at the end of the procedure was the strongest predictor of postoperative outcomes. Peri-urethral Bulkamid injections are feasible in an outpatient setting in the office using a simplified local anesthesia protocol with a great tolerance and with similar functional outcomes than previously reported. The injections have a low rate of complications and every complication has been relatively well tolerated. These options may be of great value in frail patients and those looking for a minimally invasive treatment. The local anesthesia protocol with the office setting may be of particular interest in current times with challenging access to the operative room in many institutions. Other studies are needed to confirm these findings. Polyacrylamide hydrogel (BulkamidÒ) is a relatively recent bulking agent which may have a better safety profile than previous generations. The objective of this study was to report our experience of outpatient peri-urethral injections of Bulkamid under local anesthesia in the office in female patients for stress urinary incontinence (SUI). The data of all women who underwent outpatient peri-urethral Bulkamid injections under local anesthesia in the office at a single academic center were collected prospectively between November 2019 and August 2023. This therapeutic option was offered to patients who had SUI if > 80-year-old and/or had multiple comorbidities or if they declined all other therapeutic options. Ninety-two patients were included. The mean age was 78 years (30-97). Twenty patients experienced postoperative complications (21%), nineteen were Clavien 1 complication, only one complication was Clavien = 4. The USP SUI and OAB subscores and the ICIQ-SF were all significantly improved at 3 months (p<0.001). The VAS for urethral coaptation self-assessed by the surgeon at the end of the procedure was the strongest predictor of postoperative outcomes. Peri-urethral Bulkamid injections are feasible in an outpatient setting in the office using a simplified local anesthesia protocol with a great tolerance and with similar functional outcomes than previously reported. The injections have a low rate of complications and every complication has been relatively well tolerated. These options may be of great value in frail patients and those looking for a minimally invasive treatment. The local anesthesia protocol with the office setting may be of particular interest in current times with challenging access to the operative room in many institutions. Other studies are needed to confirm these findings. Electronic Thesis or DissertationText en application/pdf1 : 1669 Kohttps://ged.univ-rennes1.fr/nuxeo/site/esupversions/28a505ae-147f-488e-af0c-4302b44fa317 Faurie Brice 1995-12-02 FR 279192037 brice.faurie@gmail.com 2023URENM183 http://www.theses.fr/2023URENM183 2023-10-18 Urologie Universite de Rennesthesis.degree.grantor_1 26693823X Doctorat (thèse d'exercice) non ouiPeyronnet Benoitintervenant_119235776X ddc:610 Peyronnet BenoitUniversite de RennesSciences et technologie, medecine, pharmacie, odontologie, droit, economie, gestion, philosophie ASCII PDF 1708933 Faurie Brice