Treatment of Female Stress Urinary Incontinence with Urethral Bulking

Purpose of ReviewTo review the current use of urethral bulking agents (UBAs) for the treatment of female stress urinary incontinence (SUI).Recent FindingsThe newest FDA-approved agent, Bulkamid (R) (2022), which has demonstrated > 60% rate of improvement at 7 years. A systematic review published in 2021 showed similar long-term success rates between Bulkamid (R) (42-70%), Coaptite (R) (60-75%), and Macroplastique (R) (21-80%). To date, direct comparisons of UBAs have not been published. Bulkamid (R) may have a more favorable side effect profiles with no cases of erosion or migration reported.Multiple UBAs are available on the market have demonstrated similar improvements in SUI with minimal adverse events. Choice of UBA should be based on surgeon comfort with technique, as each has a unique injection technique, and consideration for potential side effects depending on the material of the agent.