Which injectable to use in the treatment of intrinsic sphincter deficiency?
OBJECTIVE
Injectable agents are frequently used in the treatment of stress urinary incontinence in a variety of patients. Materials and techniques used in this therapy have evolved over time, with the relatively recent introduction of several novel therapies. The publication of recent evidence regarding these newer agents as well as older materials has provided fuel for the debate over which therapy is best.


RESULTS
Each of the agents discussed in this paper has variable biophysical properties that affect its efficacy and safety. Despite increasing evidence evaluating the various injectable materials for the treatment of stress incontinence, there is no clear data to establish any agent as superior or inferior in the various subgroups in which they are used.


CONCLUSIONS
The ideal periurethral injectable agent has not yet been identified though many of the currently used agents have acceptable efficacy in selected populations. There is active research into novel therapies that may prove effective.
Rovner
Eric S
ES
Department of Urology, Medical University of South Carolina, Charleston, South Carolina, USA. rovnere@musc.edu
Goudelocke
Colin M
CM
D000273:Adipose Tissue / Q000637:transplantation; D000818:Animals; D001672:Biocompatible Materials / Q000627:therapeutic use*; D002417:Cattle; D003094:Collagen / Q000008:administration & dosage; D004129:Dimethylpolysiloxanes / Q000008:administration & dosage; D017886:Durapatite / Q000008:administration & dosage; D006801:Humans; D007267:Injections; D011145:Polyvinyls / Q000008:administration & dosage; D023822:Tissue Engineering; D014182:Transplantation, Autologous; D014550:Urinary Incontinence, Stress / Q000188:drug therapy* / Q000601:surgery; D015040:Zirconium / Q000008:administration & dosage
D001672:Biocompatible Materials; D004129:Dimethylpolysiloxanes; D011145:Polyvinyls; C020320:ethylene-vinyl alcohol copolymer; C013830:baysilon; D003094:Collagen; D017886:Durapatite; D015040:Zirconium; C028541:zirconium oxide