Injectable treatments for female stress urinary incontinence

Table 1 Level of evidence and grade of recommendation for injectable agents (b)

Evidence summary	LE
Periurethral injection of bulking agent may provide short-term improvement in symptoms (3 mo), but not cure, in women with SUI	2a
Repeat injections to achieve therapeutic effect are often required	2a
Bulking agents are less effective than colposuspension or autologous sling for cure of SUI	2a
Adverse effect rates are lower compared to open surgery	2a
There is no evidence that one type of bulking agent is better than another type	1b
Transperineal route of injection may be associated with a higher risk of urinary retention compared to the transurethral route	2b
Recommendations	GR
Do not offer bulking agents to women who are seeking a permanent cure for stress urinary incontinence	A

LE: Level of evidence; GR: Grade of recommendation; SUI: Stress urinary incontinence.