Failure Rate, Time to Failure, and Associated Risk Factors: Polyacrylamide Hydrogel Injection for the Treatment of...

Area of Science:

• Urology
• Gynecology
• Pelvic Floor Medicine

Background:

• Stress urinary incontinence (SUI) significantly impacts quality of life and presents a substantial healthcare challenge.
• While midurethral slings are standard, periurethral bulking with polyacrylamide hydrogel (PAHG) is an emerging alternative.
• Previous studies on PAHG efficacy have been limited by small sample sizes and short follow-up periods.

Purpose of the Study:

• To evaluate the failure risk and time to failure for periurethral PAHG injections in a complex SUI patient cohort.
• To determine the likelihood of repeat injections or further surgeries after PAHG treatment.
• To identify potential risk factors associated with PAHG failure.

Main Methods:

• Retrospective review of 256 SUI patients undergoing PAHG injection between January 1, 2014, and August 31, 2020.
• Subjective PAHG failure was defined as patient-reported recurrence of SUI symptoms.
• Statistical analysis, including multivariable analysis, was performed to identify risk factors.

Main Results:

• A total of 35.9% of patients experienced PAHG failure within 2 years, with a mean time to failure of 9.06 months.
• Repeat PAHG injections were administered to 12% of patients, and 15% underwent alternative incontinence surgeries.
• Multivariable analysis did not identify any specific factors associated with an increased risk of PAHG failure.

Conclusions:

• PAHG for SUI in medically and surgically complex patients demonstrates failure rates comparable to those in uncomplicated patients.
• The findings suggest that PAHG may be a viable option for complex SUI cases, despite similar failure rates.
• Further research is warranted to explore long-term outcomes and optimize treatment strategies for PAHG in SUI management.