Bulking agents in case of treatment of female stress urinary incontinence

Abstract

The main treatment for stress urinary incontinence is surgical. However, this approach to treatment has come under scrutiny and is undergoing reevaluation in connection with the revision of the balance of risk and benefit for the patient in recent years. Increasingly, the introduction of volume-forming substances as a method of alternative care for women with mild and uncomplicated urinary incontinence during exercise is being discussed. This treatment option achieves the effect through coaptation of the urethra. Various types of substances are known solid microparticles in an absorbable liquid or gel carrier, carriers containing a hard-to-absorb homogeneous gel (without particles). Separate methods of introducing volume-forming substances are also described: transurethral and suburethral with the location of the implant in the submucous layer of the urethra, under it, and around the organ. Various authors suggest different implantation control: endoscopic and under ultrasound guidance. The review discusses the currently available volumeforming substances, methods of use, effectiveness and known complications. Besides, an original method of injection a volume-forming substance is proposed, and the first results of its application are presented.