{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T18:42:06Z","timestamp":1789756926135,"version":"4.0.1"},"reference-count":23,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T00:00:00Z","timestamp":1758153600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Bulking agents such as Bulkamid\u00ae are well-established surgical options for the treatment of stress urinary incontinence (SUI). Pelvic floor sonographic imaging is readily accessible and may assist in identifying patients who are more likely to benefit from bulking therapies. Urethral mobility appears to significantly influence treatment outcomes and can be classified into hypo-, normo-, and hypermobility. The primary aim of this study was to evaluate the impact of sonographic urethral mobility on the success rate of Bulkamid\u00ae injections. The secondary objective was to assess differences between pre- and postoperative urinary incontinence scores. Methods: In women with SUI, linear dorsocaudal movement (LDM) of the urethra was measured sonographically. The International Consultation on Incontinence Modular Questionnaire\u2014Urinary Incontinence Short Form (ICIQ-UI SF) was completed prior to Bulkamid\u00ae injection. Patients were categorized into hypo-, normo-, and hypermobility groups based on their LDM measurements. Results: A total of 130 patients participated, with 101 undergoing both pre- and postoperative sonographic assessment. The difference in LDM before and after treatment was calculated. Patients with normomobile urethras (n = 79) exhibited the greatest mean improvement in continence scores, with LDM changes ranging from 6 to 24 mm and an average ICIQ-UI SF score reduction of 3.8 points. Patients with hypomobile (n = 16) or hypermobile urethras (n = 6) also demonstrated improvements, but to a lesser extent than the normomobile group. Conclusions: This study indicates that patients with a normomobile urethra experience the most significant improvement in continence outcomes following Bulkamid\u00ae injection. Urethral mobility assessment via sonography may serve as a valuable preoperative tool and appears to play a crucial role in predicting treatment success with bulking agents.<\/jats:p>","DOI":"10.3390\/jcm14186555","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T09:32:32Z","timestamp":1758187952000},"page":"6555","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Predictive Measurement of Urethral Mobility for Successful Transurethral Bulkamid Application in Women with Stress Urinary Incontinence"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8110-1211","authenticated-orcid":false,"given":"Norbert","family":"Nosal","sequence":"first","affiliation":[{"name":"Gynecology and Obstetrics, Elisabeth Hospital Essen, 45138 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Gerling","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics, Elisabeth Hospital Essen, 45138 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Kuhn","sequence":"additional","affiliation":[{"name":"Division of Uorgynecology, Inselspital Bern, Women\u2019s Hospital, Switzerland and University of Bern, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"Pfleiderer","sequence":"additional","affiliation":[{"name":"University of Cologne, Faculty of Medicine and University Hospital of Cologne, Department of Gynecology and Oncology, Division of Urogynecology, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6297-5377","authenticated-orcid":false,"given":"Sunhwa","family":"Baek","sequence":"additional","affiliation":[{"name":"University of Cologne, Faculty of Medicine and University Hospital of Cologne, Department of Gynecology and Oncology, Division of Urogynecology, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1627-1871","authenticated-orcid":false,"given":"Sebastian","family":"Ludwig","sequence":"additional","affiliation":[{"name":"University of Cologne, Faculty of Medicine and University Hospital of Cologne, Department of Gynecology and Oncology, Division of Urogynecology, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1055\/a-1967-1726","article-title":"Diagnosis and Therapy of Female Urinary Incontinence. 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