Urolastic®, a new bulking agent for treatment of stress urinary incontinence: a systematic review and meta-analysis

Introduction and hypothesis The aim of the present systematic review and meta-analysis was to assess the effectiveness and safety of injections of the new bulking agent Urolastic® in the treatment of patients with stress urinary incontinence (SUI). Methods A systematic search was carried out to select observational and experimental studies on Urolastic® in female patients with SUI. Three different databases, Pubmed, the Cochrane Central Register of Controlled Trials, and Scopus, were used to retrieve scientific articles published from their inception to 31 January 2018. Results Eight full texts were evaluated but only five were selected for the qualitative and quantitative analyses. Duration of follow-up after Urolastic® injections was significantly heterogeneous, ranging from 6 to 24 months. Secondary injections were needed in 16.7%–35.0% of the treated patients. The pooled proportion of secondary injections was 20% (95% CI: 15%–24%; I2:0%). Subjective improvement, measured by different means (i.e., patient global impression of improvement PGI-I score) was only assessed by 40% of the selected papers and was > 80% in two cohorts. The objective treatment success was evaluated by four (80.0%) papers and was achieved in all cohorts with a wide proportional range: from 32.7% (i.e., patients without objective SUI symptomcough tests and with a negative pad test) to 67.0%. Its pooled proportionwas 57%(95% CI: 38%–75%; I2: 82.3%). Conclusions Urolastic® showed effectiveness in patients with SUI during a follow-up period of 6–24 months.