Polyacrylamide hydrogel (Bulkamid®) for stress urinary incontinence in women: a systematic review of the literature
- 611 Downloads
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.
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.
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.
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.
KeywordsBulkamid Polyacrylamide hydrogel Stress urinary incontinence
Conflicts of interest
- 1.National Institute for Health and Care Excellence (2013) NICE guidelines [CG171]. Urinary incontinence: the management of urinary incontinence in women. http://guidance.nice.org.uk/CG171
- 4.Committee Opinion No. 603: Evaluation of uncomplicated stress urinary incontinence in women before surgical treatment (2014). Obstet Gynecol 123(6):1403–1407Google Scholar
- 5.Ter Meulen PH, Berghmans LC, van Kerrebroeck PE (2003) Systematic review: efficacy of silicone microimplants (Macroplastique) therapy for stress urinary incontinence in adult women. Eur Urol 44(5):573–582Google Scholar
- 17.Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 339:b2700PubMedCentralCrossRefPubMedGoogle Scholar
- 22.Beraru A, Droupy S, Wagner L, Soustelle L, Muyschondt C, Ben Naoum K, Grés P, Boukaram M, Costa P (2014) Efficacy of periurethral injections of polyacrylamide hydrogel (Bulkamid®) and quality of life of patients with urinary incontinence due to sphincter deficiency (IUE-IS). Prog Urol 24(8):501–510CrossRefPubMedGoogle Scholar