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Current role of injectable agents for female stress urinary incontinence
1Division of Urology, University of Toronto, Sunnybrook and Women's Health Sciences Centre, Toronto, Ontario, Canada.
Aim:
The current role of injectable agents in the management for female stress urinary incontinence is reviewed.
Materials And Methods:
Published manuscripts for collagen, silicone microparticles, carbon beads, hyaluronic acid dextranomer and two investigational agents were evaluated.
Results:
While injectable agents were used in the past for pure intrinsic sphincter deficiency there is good evidence that patients with hypermobility respond similarly. Collagen has been the most widely reported agent to date. Comparative studies with surgery have demonstrated inferior efficacy but a recent study showed a similar quality of life outcome. Newer agents have been designed for superior efficacy and durability. However, of the new agents carbon beads was not shown to be superior and the results of randomized trials of silicone microparticles and hyaluronic acid dextranomer compared to collagen have not yet been reported. All currently used agents appear to be very safe.
Conclusions:
Injectable agents have been shown to have efficacy in the management of stress incontinence in women and should be readily available as a treatment option. The definite superiority of one agent over another has not yet been established.
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