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Urolastic — Polymerizing Silicone Gel (PDMS-U)

Urolastic is an in-situ polymerizing polydimethylsiloxane bulking agent — injected as a liquid that polymerizes into a solid elastomer within the tissue.

Composition & Delivery​

  • Liquid PDMS polymer mixed with a catalyst immediately before injection
  • Polymerizes to a solid silicone elastomer within minutes
  • Creates a permanent, non-absorbable submucosal bulking depot

Efficacy & Safety Concerns​

  • Erosion rates up to 24.6% — the single largest safety signal among modern bulking agents[1][2]
  • High rate of symptomatic mass effect and extrusion
  • Use has declined substantially where alternatives exist

Current Status​

Urolastic remains available in some markets but is not recommended as first-line given the erosion profile. Revision/removal can be technically difficult because the polymerized silicone is firm and adherent to surrounding tissue.

References​

1. Hoe V, Haller B, Yao HH, O'Connell HE. Urethral Bulking Agents for the Treatment of Stress Urinary Incontinence in Women: A Systematic Review. Neurourology and Urodynamics. 2021;40(6):1349–1388. doi:10.1002/nau.24696

2. Hussain SM, Bray R. Urethral Bulking Agents for Female Stress Urinary Incontinence. Neurourology and Urodynamics. 2019;38(3):887–892. doi:10.1002/nau.23924

See also: Bulkamid.