Bulking agents for minimally invasive correction of stress urinary incontinence in women

Abstract

BACKGROUND:The study is relevant due to the widespread prevalence of stress urinary incontinence in women and the search for minimally invasive and safe treatment methods. AIM:The aim of this study was to present data based on modern evidence-based information on the effectiveness of urethral bulking agents and their safety in stress urinary incontinence treatment in women. MATERIALS AND METHODS:A review of the literature (original articles, systematic reviews) on the use of urethral bulking agents for stress urinary incontinence treatment in women was carried out. RESULTS:Urethral bulking agents for stress urinary incontinence treatment are effective due to the creation of additional bulk in the paraurethral area without fibrosis or because of inflammation followed by fibrous tissue formation. The efficacy and complications depend on the properties of the used urethral bulking agents. Since the performed studies are heterogeneous and the methods for evaluating the use of bulking fillers in stress urinary incontinence treatment vary, it is difficult to comparatively characterize urethral bulking agents to determine the most effective one. The search is being conducted for an ideal proper filler, which should be biocompatible and non-immunogenic and maintain a long-term therapeutic effect. CONCLUSIONS:Urethral bulking injections are an alternative therapy for women with stress urinary incontinence who are informed about its short-term effect and are expecting to avoid the risk of possible complications after surgery. Promising is to be regarded as the use of new urethral bulking agents based on hyaluronic acid with an optimal choice of concentration, degree of crosslinking and type of crosslinking agent to ensure maximum duration of action and minimum side effects.