Urethral bulking agents

Abstract

Urethral bulking agent (UBA) injection is a technique for treating stress urinary incontinence (SUI) in patients with intrinsic sphincter deficiency. UBAs each have a unique composition and mechanism of action for creating the urethral bulk necessary for effective urethral coaptation to prevent the leakage of urine. UBAs can be synthetic or biologic; synthetic UBAs can further be subdivided into particulate and non-particulate agents. UBAs are injected transurethrally, periurethrally, or through device-guided dispensers; injection can be performed under local or general anesthesia. Adverse treatment-related effects are mostly minor and transient, although rare serious complications have been reported. Subjective and objective cure rates vary between patient populations and the type of UBA used, but many patients ultimately require reinjection for recurrent symptoms. While long-term success rates tend to be lower than other surgical options, UBAs represent an excellent minimally invasive approach in properly selected patients for treating SUI.