Long‐term outcomes of polyacrylamide hydrogel treatment in women with stress urinary incontinence

Hoe, Venetia; Yao, Henry Han‐I; Gough, Karla; O’Connell, Helen

doi:10.1111/bju.15717

Cited by 4 publications

(5 citation statements)

References 9 publications

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“…In UDI-6 and IIQ-7, total scores showed lessened distress caused by urinary incontinence symptoms from the baseline in both groups, which is in line with previous studies after mid-urethral sling surgery [ 6 ] and less studied PAHG [ 25 ]. The improvement in QoL was also sustained from short-term [ 26 ] to 3 years.…”

Section: Discussionsupporting

confidence: 90%

Quality of life and sexual function after tension-free vaginal tape and polyacrylamide hydrogel injection for primary stress urinary incontinence: 3-year follow-up from a randomized clinical trial

Itkonen Freitas,

Isaksson,

Rahkola-Soisalo

et al. 2023

Int Urogynecol J

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Introduction and hypothesis To assess quality of life (QoL) and sexual function outcomes at 3 years after tension-free vaginal tape (TVT) and polyacrylamide hydrogel injection (PAHG) for stress urinary incontinence (SUI). Methods In this randomized trial comparing TVT (n = 104) and PAHG (n = 108), we assessed changes in QoL and sexuality using the Urogenital Distress Inventory (UDI-6), Incontinence Impact Questionnaire, Short Form (IIQ-7), Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) and RAND-36 Item Health Survey (RAND-36) at baseline and at 3 years. This is a secondary analysis of a randomized, noninferiority trial comparing patient satisfaction after TVT and PAHG. Results In both groups, incontinence-related QoL improved from the baseline (p < 0.00), except for difficulty emptying the bladder and pain/discomfort. Total scores of UDI-6 and IIIQ-7 were lower for TVT compared to PAHG (p < 0.00) indicating better QoL at 3 years. Urinary incontinence with sexual activity or fear of incontinence restricting sexual activity improved in both groups (p < 0.00), with higher scores for physical section subscale in PISQ-12 (p = 0.02) for TVT. Physical and social functioning (RAND-36) improved from the baseline in both groups (p < 0.01) with a better outcome in the TVT group for physical functioning (p = 0.00). Conclusions Both TVT and PAHG improve QoL and sexual function in primary SUI with better incontinence and health-related QoL scores in the TVT group compared to the PAHG group at 3 years.

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Section: Discussionsupporting

confidence: 90%

Quality of life and sexual function after tension-free vaginal tape and polyacrylamide hydrogel injection for primary stress urinary incontinence: 3-year follow-up from a randomized clinical trial

Itkonen Freitas,

Isaksson,

Rahkola-Soisalo

et al. 2023

Int Urogynecol J

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“…We undertook a cross‐sectional study with retrospective case note review in female patients who underwent transurethral polyacrylamide hydrogel injections for the treatment of SUI by a single urologist at a large metropolitan hospital in Australia between January 2012 and December 2019 7 . Ethical approval was obtained from the institutional HREC (EH2020‐621).…”

Section: Methodsmentioning

confidence: 99%

Factors associated with polyacrylamide hydrogel outcomes in women with stress urinary incontinence

et al. 2023

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Knowledge of factors associated with superior outcomes in women treated with urethral bulking agents for stress urinary incontinence (SUI) remains limited. The aim of this study was to examine associations between post-treatment outcomes in women who had undergone polyacrylamide hydrogel injections for SUI, and physiological and self-reported variables captured during pre-treatment clinical evaluation. A cross-sectional study was undertaken in female patients treated for SUI with polyacrylamide hydrogel injections by a single urologist between January 2012 and December 2019. Post-treatment outcome data were gathered in July 2020 using the Patient Global Impression of Improvement (PGI-I), Urinary Distress Inventory-short form (UDI-6), Incontinence Impact Questionnaire (IIQ7), and International Consultation on Incontinence Questionnaire Short Form (ICIQ SF). All other data were gathered from women's medical records including pre-treatment patient-reported outcomes. Associations between post-treatment outcomes and pre-treatment physiological and self-reported variables were investigated using regression models. One hundred seven of the 123 eligible patients completed post-treatment patientreported outcome measures. Mean age was 63.1 years (range 25-93 years), and median time between first injection and follow-up was 51 months (inter-quartile range 23.5-70 months). Fifty-five (51%) women had a successful outcome based on PGI-I scores. Women with type 3 urethral hypermobility pre-treatment were more likely to report treatment success (PGI-I). Poor bladder compliance pre-treatment was associated with greater urinary distress, frequency and severity (UDI-6 and ICIQ) post-treatment. Older age was associated with worse urinary frequency and severity (ICIQ) post-treatment. Associations between patient-reported outcomes and time between first injection and follow-up were trivial and not statistically significant.Severity of pre-treatment incontinence impact (IIQ-7) was associated with worse incontinence impact post-treatment. Type 3 urethral hypermobility was associated with a successful outcome, whereas pre-treatment incontinence impact, poor bladder compliance and older age were associated with poorer self-reported outcomes.Long-term efficacy appears to hold in those who responded to initial treatment.

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“…A systematic review and meta-analysis reported an 80% cure and improvement rate for Bulkamid ® after failed sling insertion [ 37 ]. Re-injection rates to improve continence varied significantly between studies, ranging from 0% to 77% [ 42 , 44 , 45 ], while the median time between injections was 3 months [ 45 ].…”

Section: Bulking Agents To Treat Suimentioning

confidence: 99%

“…A retrospective dataset analysis of women over 65 years showed that patients receiving bulking agents were notably sicker and have a shorter life expectancy compared to those undergoing sling insertion, suggesting these factors guide patient selection [ 55 ]. Bulking therapy is more successful for patients with mild SUI [ 45 , 56 , 57 ] or with ISD [ 58 ]. Patients younger than 60 years preferred an office setting rather than an operation theatre [ 59 ].…”

Section: Bulking Agents To Treat Suimentioning

confidence: 99%

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Current Treatment of Stress Urinary Incontinence by Bulking Agents and Laser Therapy—An Update

Sikora,

Gamper,

Zivanovic

et al. 2024

JCM

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Stress urinary incontinence (SUI) affects around 20% of women. In addition to the established suburethral sling insertion, two less invasive approaches are of interest today: urethral bulking agents and vaginal laser therapy. This review discusses articles through December 2023 identified by a PubMed literature search using the keywords “incontinence” and “bulking” or “laser”. Although the two approaches are less effective than sling insertions, there are specific conditions in which one or the other technique is more advantageous. Injecting bulking agents into the urethra only takes some minutes and works without general anesthesia. The method is particularly suited for elderly, frail, or obese patients with multiple comorbidities, but is also applicable for all patients and in combination with other therapies. Generally, the safety profile is good but differs between bulking materials. Two laser types—the Erbium:YAG laser with SMOOTH-mode and the fractional ablative CO2 laser—deliver heat into the tissue to induce tissue tightening and regeneration. Intravaginal laser therapy improves mild to moderate SUI, while studies describe how intraurethral laser therapy is also beneficial for severe SUI. Young women between childbirths, as well as postmenopausal women, may benefit from laser therapy. The method is safe, can be performed on an outpatient basis, and does not require any artificial material.

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Long‐term outcomes of polyacrylamide hydrogel treatment in women with stress urinary incontinence

Cited by 4 publications

References 9 publications

Quality of life and sexual function after tension-free vaginal tape and polyacrylamide hydrogel injection for primary stress urinary incontinence: 3-year follow-up from a randomized clinical trial

Quality of life and sexual function after tension-free vaginal tape and polyacrylamide hydrogel injection for primary stress urinary incontinence: 3-year follow-up from a randomized clinical trial

Factors associated with polyacrylamide hydrogel outcomes in women with stress urinary incontinence

Current Treatment of Stress Urinary Incontinence by Bulking Agents and Laser Therapy—An Update

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