In her words: Women's experiences of urethral bulking for stress urinary incontinence

Background: Stress Urinary Incontinence (SUI) is involuntary bladder leakage during physical exertion or exercise. When first-line symptom management is insufficient, surgical interventions such as urethral bulking (UB) can be considered. Whilst not suitable for all women, UB may provide symptomatic relief without the complexities of major surgery. Preparing women for procedural expectations, outcomes, and risks of UB may foster control during treatment choice. However, research on women’s experiences of UB and its impact on SUI symptoms and quality of life (QoL) is limited. Adding experiential evidence to existing information could support informed counselling, particularly given stigma and embarrassment.Aim: To explore women’s experiences of UB and any subsequent differences to SUI symptoms and QoL in order to support fully informed treatment decision processes for other women and healthcare practitioners. Method: Women (n=12) participated in virtual semi-structured interviews, answering open-ended questions supporting the research aim. Interviews were analysed using reflexive thematic analysis.Results: Two overarching themes were identified: ‘Having Choice and Feeling in Control’ (subthemes: ‘Healthcare Professionals: The Manner Matters’; ‘An Unknown Treatment’; ‘Pain Relief: “that was just the way they do it”; and “Am I going to be able to pee?”) and ‘A Return to ‘Normal’?’ (subthemes: ‘Hope and Disappointment’; and “Left in Limbo”.)Conclusion: Inconsistent empathic, patient-centred care and limited information about UB shaped women’s experiences, treatment attitudes, self-management, and post-treatment views of symptom severity and QoL. Peer-based experiential information could aid decision-making and manage expectations, whilst variable efficacy rates may warrant psychological support to address SUI’s psychosocial impact.