Pd28-04 Management of Complications in Use of Urethral Bulking Agents in Women for Stress Urinary Incontinence – A Meta-Analysis

Islam, Majdee; Wadhwa, Harpreet; Dobbs, Ryan W.; Kocjancic, Ervin

doi:10.1016/j.juro.2015.02.1901

Cited by 1 publication

(1 citation statement)

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“…Islam et al43 conducted a meta-analysis of 1022 studies published between 1996 and 2014 involving 4326 patients treated with one of six bulking agents using reports that overlap with the information cited previously in this paper. Of the 1999 complications reported, 3.8% were considered major (Clavien III) and required either incision and drainage or a more invasive procedure.…”

Section: Safetymentioning

confidence: 99%

<p>Particulate Versus Non-Particulate Bulking Agents In The Treatment Of Stress Urinary Incontinence</p>

Chapple¹,

Dmochowski²

2019

RRU

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Stress urinary incontinence (SUI) has been treated surgically with the midurethral sling but in recent years, this option has come under scrutiny and the risk–benefit balance continues to be reviewed. The low-risk alternative for women with uncomplicated SUI is the bulking agent, which aims to achieve continence through coaptation of the urethra. Two classes of bulking agents can be identified: those made from solid microparticles in an absorbable liquid or gel carrier (particulate agents) and those comprising a homogenous gel (non-particulates) that resists absorption. Polydimethylsiloxane®, carbon-coated zirconium oxide®, calcium hydroxyapatite® and polyacrylate polyalcohol copolymer® are currently marketed particulate agents. With the exception of calcium hydroxyapatite, the particles are non-degradable. Each agent achieves its long-term bulking effect through reactive changes around the persisting particles while the carrier volume is lost. Bulkamid® is a non-particulate agent with the bulking effect resulting from the volume of gel injected. The lasting network of fine fibers formed by the host tissue anchors the gel in situ. Foreign-body granulomas, erosion and migration/material extrusion and loss of bulk have been observed in connection with the particle-based products. Bulkamid may be mechanistically less liable to these events; however, there are minimal data directly comparing the two types of bulking agent. The question of durability is inevitable based on their differing modes of action.

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Section: Safetymentioning

confidence: 99%