Use of Injectable Urethral Bulking Agents in the Management of Stress Urinary Incontinence

The use of injectable bulking agents is a well-established approach to management of patients with stress urinary incontinence (SUI). No single bulking agent to date has been shown to be superior or consistently durable in the literature. Novel therapeutic strategies, including the use of injectable, muscle-derived stem cell therapy, have shown promising results in investigational stages. Urethral bulking agent therapy can be helpful in the early management of men with SUI following radical prostatectomy, and in women with SUI due to intrinsic sphincter deficiency, urethral hypermobility, or in the setting of failed midurethral sling placement. Despite their widespread use historically, biocompatible agents have been supplanted in recent years by synthetic agents secondary to their potentially improved durability and nonimmunogenic profiles.