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Urethral Bulking Agent as a Salvage Procedure for Female Stress Urinary Incontinence: A Systematic Review and
Olivia Hoffman1,2,3, Jeffrey Jiang4,5, Sayar Rashid6,4
1Department of Urology, Western Health, Melbourne, VIC, Australia. olivia.hoffman88@hotmail.com.
International Urogynecology Journal
|October 9, 2025
Summary
Urethral bulking agents (UBAs) are an effective salvage treatment for recurrent stress urinary incontinence (rSUI). This minimally invasive option offers good patient satisfaction and improvement rates for women seeking alternatives after prior procedures.
Area of Science:
- Urology
- Gynecology
- Female Pelvic Medicine and Reconstructive Surgery
Background:
- Recurrent stress urinary incontinence (rSUI) presents significant challenges for patients and clinicians.
- Limited evidence exists on optimal salvage treatments following failed primary procedures for rSUI.
Purpose of the Study:
- To evaluate the efficacy of urethral bulking agents (UBAs) as a salvage therapy for women with rSUI.
- To synthesize existing data on patient-reported and objective outcomes of UBA use in the rSUI salvage setting.
Main Methods:
- A systematic review and meta-analysis adhering to PRISMA guidelines.
- Comprehensive literature search across Embase, PubMed, and Cochrane databases.
- Inclusion of 20 studies analyzing UBA efficacy for rSUI.
Main Results:
- Pooled patient satisfaction with UBAs reached 77.00%.
- Pooled objective cure and improvement rates were 56.00%.
- Re-intervention rates following salvage UBAs ranged from 9.80% to 42.00%.
Conclusions:
- Urethral bulking agents represent a viable and minimally invasive salvage option for rSUI.
- UBAs provide a favorable profile with low complication rates and rapid recovery for eligible patients.
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