Evidence-based recommendations on intramural urethral bulking procedures for stress urinary incontinence in women. Intramural urethral bulking aims to augment the urethral wall and increase the urethral closure force. 

 In July 2018, the Government announced a period of ‘high vigilance restriction’ on the use of a group of procedures, including this procedure, to treat stress urinary incontinence and pelvic organ prolapse, in England. This followed a recommendation by Baroness Cumberlege, who is chairing an independent review of surgical mesh procedures and has heard from women and families affected by them. For details, see the letter from NHS England and NHS Improvement to trust medical directors. The high vigilance restriction period was extended in March 2019. In April 2019, we updated our guideline on urinary incontinence and pelvic organ prolapse and published patient decision aids to support people to make informed decisions about surgery for stress urinary incontinence, uterine prolapse and vaginal vault prolapse.

Guidance development process

How we develop NICE interventional procedures guidance

Coding recommendations

M56.3 Endoscopic injection of inert substance into outlet of female bladder