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Introduction and Hypothesis <p>Recurrent stress urinary incontinence (rSUI) poses a management challenge to clinicians and patients due to limited evidence on optimal salvage options following failed prior procedures. This study aims to assess the efficacy of urethral bulking agents (UBAs) as a salvage treatment for rSUI.</p> Methods <p>A systematic review and meta-analysis was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A search was conducted using Embase (Ovid), PubMed (Medline) and Cochrane databases. All studies involving women who underwent UBA for rSUI were included. Five hundred sixty-three studies were screened for inclusion; 249 were excluded as duplicates and 261 studies were excluded as irrelevant, leaving 53 full-text studies for eligibility assessment. Thirty-nine studies were excluded during full text review, leaving 14 studies that met inclusion criteria. The reference lists of these studies were screened to identify a further six studies. Ultimately, a total of 20 studies were selected for qualitative and quantitative analysis.</p> Results <p>The selected studies utilised a variety of subjective patient-reported outcome measures and objective measures. Subjective patient satisfaction ranged from 45.10% to 96.50%, with a pooled rate of 77.00%. Objective cure and improvement ranged from 19.60% to 83.00%, with a pooled rate of 56.00%. Patient-reported cure and improvement ranged from 67% to 83% in primary UBA populations, and 56.50% to 75.00% in salvage UBA populations. Rates of re-intervention following salvage UBAs ranged from 9.80% to 42.00%.</p> Conclusions <p>UBAs offer a viable salvage option for women with rSUI, especially those desirous of a minimally invasive approach with low complication rates and rapid recovery.</p>

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Urethral Bulking Agent as a Salvage Procedure for Female Stress Urinary Incontinence: A Systematic Review and Meta-Analysis

  • 期刊论文

  • 发表日期：

    2025年10月9日

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  • Olivia Hoffman,
  • Jeffrey Jiang,
  • Sayar Rashid,
  • Henry H. Yao,
  • Helen E. O’Connell,
  • Johan Gani

摘要

Introduction and Hypothesis

Recurrent stress urinary incontinence (rSUI) poses a management challenge to clinicians and patients due to limited evidence on optimal salvage options following failed prior procedures. This study aims to assess the efficacy of urethral bulking agents (UBAs) as a salvage treatment for rSUI.

Methods

A systematic review and meta-analysis was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A search was conducted using Embase (Ovid), PubMed (Medline) and Cochrane databases. All studies involving women who underwent UBA for rSUI were included. Five hundred sixty-three studies were screened for inclusion; 249 were excluded as duplicates and 261 studies were excluded as irrelevant, leaving 53 full-text studies for eligibility assessment. Thirty-nine studies were excluded during full text review, leaving 14 studies that met inclusion criteria. The reference lists of these studies were screened to identify a further six studies. Ultimately, a total of 20 studies were selected for qualitative and quantitative analysis.

Results

The selected studies utilised a variety of subjective patient-reported outcome measures and objective measures. Subjective patient satisfaction ranged from 45.10% to 96.50%, with a pooled rate of 77.00%. Objective cure and improvement ranged from 19.60% to 83.00%, with a pooled rate of 56.00%. Patient-reported cure and improvement ranged from 67% to 83% in primary UBA populations, and 56.50% to 75.00% in salvage UBA populations. Rates of re-intervention following salvage UBAs ranged from 9.80% to 42.00%.

Conclusions

UBAs offer a viable salvage option for women with rSUI, especially those desirous of a minimally invasive approach with low complication rates and rapid recovery.