Urethral bulking aims to improve urethral mucosal coaptation, and thus outlet resistance, in an effort to limit stress-induced leakage. While efforts have been made to employ bulking agents to treat stress urinary incontinence (SUI) for more than 100 years, we remain wanting for the perfect injectable. Regardless of the agent studied, efficacy is modest at best, repeat injections are the norm, and longterm followup is conspicuously lacking. This treatment, however, fills an important need in our armamentarium against SUI, serving those patients who are not candidates for more invasive interventions and those with multiple prior failed surgeries. This review offers a contemporary discussion on the role of periurethral bulking therapy in Canada, along with practical aspects of its application.

MIS constitutes an increasingly significant component of surgical volume in Canadian urology residencies with a reciprocal decrease in exposure to open surgery. These trends necessitate ongoing evaluation to maintain the integrity of postgraduate urologic training.

Polyembolokoilamania is the insertion of foreign objects into body orifices for sexual gratification. While the retrieval of these objects from the urethra and bladder is a well-known task among urologists, we present a rare case of an usual and serious injury from this practice: complete avulsion of the urethra at the penoscrotal junction. A single-stage urethroplasty was used to reconstruct the urethra with good result. The patient motivation, as well as concomitant medical or psychological conditions, should be explored in order to prevent further occurences.

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Both our case series and the systematic review of the literature demonstrated that endoscopic treatment of lower urinary tract foreign bodies after stress incontinence surgery has good success rates and minimal morbidity.

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