Anushuya Devi Kasi1, Vasilios Pergialiotis2, Despina N Perrea3, Azar Khunda4, Stergios K Doumouchtsis5,6. 1. Department of Obstetrics and Gynaecology, Urogynaecology Unit, St. George's University Hospitals NHS Foundation Trust, London, SW17 0QT, UK. dranushuya@gmail.com. 2. Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Medical School, University of Athens, Athens, Greece. pergialiotis@hotmail.com. 3. Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Medical School, University of Athens, Athens, Greece. dperrea@lessr.eu. 4. Department of Obstetrics and Gynaecology, Urogynaecology Unit, St. George's University Hospitals NHS Foundation Trust, London, SW17 0QT, UK. azarkhunda@yahoo.co.uk. 5. Department of Obstetrics and Gynaecology, Urogynaecology Unit, St. George's University Hospitals NHS Foundation Trust, London, SW17 0QT, UK. sdoum@yahoo.com. 6. Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Medical School, University of Athens, Athens, Greece. sdoum@yahoo.com.
Abstract
INTRODUCTION AND HYPOTHESIS: Polyacrylamide hydrogel (PAHG, Bulkamid®) is one of several injectable agents currently used for the treatment of women with urinary stress incontinence. Although bulking agents appear to have lower efficacy rates compared to other surgical treatments, current evidence based on large prospective or comparative studies as well as systematic reviews is limited. The purpose of this study was to conduct a systematic review on the efficacy of PAHG in the treatment of female patients with stress urinary incontinence with regard to reproducibility, feasibility, safety and clinical outcome. METHODS: We searched MEDLINE (1966-2015), Scopus (2004-2015), POPLINE (1974-2015) and ClinicalTrials.gov (2008-2015) along with reference lists of electronically retrieved studies. Observational studies, prospective, retrospective and randomized controlled studies were included. Two reviewers independently selected studies, assessed the risk of bias and tabulated data to structured forms. RESULTS: We included 8 studies, which enrolled a total of 767 patients who received treatment with PAHG. We found that 186 of 767 women (24.3 %, range 12-35 %) required reinjection in order to achieve adequate efficacy. The most frequent adverse effects were pain at the site of injection (4-14 %) and urinary tract infections (3-7 %). Both the number of incontinence episodes/24 h and the number of ml/24 h were significantly reduced 1 year following treatment and the quality of life of patients was significantly improved. CONCLUSIONS: PAHG is a safe intervention for treating women with stress urinary incontinence, but repeat injections are often required. Further research is mandated in the field in order to compare its efficacy to other bulking agents.
INTRODUCTION AND HYPOTHESIS: Polyacrylamide hydrogel (PAHG, Bulkamid®) is one of several injectable agents currently used for the treatment of women with urinary stress incontinence. Although bulking agents appear to have lower efficacy rates compared to other surgical treatments, current evidence based on large prospective or comparative studies as well as systematic reviews is limited. The purpose of this study was to conduct a systematic review on the efficacy of PAHG in the treatment of female patients with stress urinary incontinence with regard to reproducibility, feasibility, safety and clinical outcome. METHODS: We searched MEDLINE (1966-2015), Scopus (2004-2015), POPLINE (1974-2015) and ClinicalTrials.gov (2008-2015) along with reference lists of electronically retrieved studies. Observational studies, prospective, retrospective and randomized controlled studies were included. Two reviewers independently selected studies, assessed the risk of bias and tabulated data to structured forms. RESULTS: We included 8 studies, which enrolled a total of 767 patients who received treatment with PAHG. We found that 186 of 767 women (24.3 %, range 12-35 %) required reinjection in order to achieve adequate efficacy. The most frequent adverse effects were pain at the site of injection (4-14 %) and urinary tract infections (3-7 %). Both the number of incontinence episodes/24 h and the number of ml/24 h were significantly reduced 1 year following treatment and the quality of life of patients was significantly improved. CONCLUSIONS:PAHG is a safe intervention for treating women with stress urinary incontinence, but repeat injections are often required. Further research is mandated in the field in order to compare its efficacy to other bulking agents.
Authors: Gunnar Lose; Helle Christina Sørensen; Susanne M Axelsen; Christian Falconer; Kurt Lobodasch; Tosson Safwat Journal: Int Urogynecol J Date: 2010-07-20 Impact factor: 2.894
Authors: Gustavo Bello; Ian T Jackson; Mustafa Keskin; Chris Kelly; Khaled Dajani; Rebecca Studinger; Elizabeth M H Kim; Denis Lincoln; Boris Silberberg; Andrus Lee Journal: Plast Reconstr Surg Date: 2007-04-01 Impact factor: 4.730
Authors: A Beraru; S Droupy; L Wagner; L Soustelle; C Muyschondt; K Ben Naoum; P Grés; M Boukaram; P Costa Journal: Prog Urol Date: 2014-03-22 Impact factor: 0.915
Authors: Ana Maria H M Bianchi-Ferraro; Zsuzsanna I K Jarmy-DiBella; Rodrigo de Aquino Castro; Maria Augusta T Bortolini; Marair G F Sartori; Manoel J B C Girão Journal: Int Urogynecol J Date: 2014-03-19 Impact factor: 2.894
Authors: Allert M de Vries; Hendrikje M K van Breda; Jimmy G Fernandes; Pieter L Venema; John P F A Heesakkers Journal: Urol Int Date: 2017-02-03 Impact factor: 2.089
Authors: Ron J Jankowski; Le Mai Tu; Christopher Carlson; Magali Robert; Kevin Carlson; David Quinlan; Andreas Eisenhardt; Min Chen; Scott Snyder; Ryan Pruchnic; Michael Chancellor; Roger Dmochowski; Melissa R Kaufman; Lesley Carr Journal: Int Urol Nephrol Date: 2018-10-15 Impact factor: 2.370
Authors: Stefan Mohr; Christine Marthaler; Sara Imboden; Ash Monga; Michel D Mueller; Annette Kuhn Journal: Int Urogynecol J Date: 2017-04-17 Impact factor: 2.894
Authors: Giampiero Capobianco; Antonio Azzena; Laura Saderi; Francesco Dessole; Salvatore Dessole; Giovanni Sotgiu Journal: Int Urogynecol J Date: 2018-06-23 Impact factor: 2.894