Bulking agents: anesthesia techniques.

Bulking therapy for the minimally invasive treatment of stress urinary incontinence(SUI) may be offered to women with urodynamic SUI, wishing to avoid the complicationsassociated with more invasive surgery, on the basis of low operative morbidity and low longtermsuccess rates. These bulking agents may be injected by a retrograde or antegradetechnique in the periurethral tissue around the bladder neck and proximal urethra. This therapyis strongly dependent on the anesthetic technique of choice; moreover its applicationas an outpatient procedure implies the potential for a cost-effective treatment for selectedpatients with SUI. In the present paper all factors affecting the choice of different types ofanesthetic techniques are discussed. (