A new bulking agent (polyacrylamide hydrogel) for treating stress urinary incontinence in women

OBJECTIVE: To evaluate the efficacy and safety of a transurethral injection with polyacrylamide hydrogel (PAHG) for treating stress urinary incontinence (SUI) in women. PATIENTS AND METHODS: The study comprised 17 women with pure SUI and eight with mixed incontinence (age range 35-84 years). Between November 2001 and November 2003, the women were injected into the urethral wall with a PAHG (Aquamid, Contura International A/S, Denmark), a homogenous, highly biocompatible, atoxic, nonresorbable sterile watery gel consisting of approximately 2.5% cross-linked polyacrylamide and 97.5% nonpyrogenic water. The women were followed prospectively (assessed at 1, 3 and 12 months after treatment) and their clinical outcome documented. RESULTS: Four women did not complete the study, and of the remainder, eight (38%) were subjectively dry and a further nine (43%) improved. Objectively, urine leakage/24 h was decreased by 93% and the number of incontinence episodes by 87%. Quality-of-life measures improved significantly in all domains other than general health perception. There were no significant changes of urodynamic variables. Treatment-related adverse events were recorded in 16 women. Urinary tract infection (10 cases) and urinary retention (five cases) were most common. There were no injection site reactions. CONCLUSION: PAGH seems to be a promising new bulking agent for the treatment of SUI.