Abstract

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• The purpose of this review is to summarize the results of reports of injectable agents for the treatment of female urinary stress incontinence. Five agents were reviewed: collagen, Teflon, autologous fat, silicone microparticles, and silicone microballoons. Collagen was the most frequently reported agent and yielded short-term cure and improved rates of 74%-100%. This deteriorated to approximately 57% with longer term follow-up. Teflon has similarly lower longer term than short-term success rates, at 33%-76%. The reported local complications and the potential for particle migration have resulted in its lack of widespread acceptance. Autologous fat has yielded the lowest success rate. Longer term success in a small number of silicone microparticle articles was similar to the other injectables at approximately 60%. Early success with silicone microballoons was 70%. The technique is generally free of major morbidity. The indication for injectables is intrinsic sphincter deficiency but hypermobility is not a contraindication. Long-term durability, cost effectiveness, and some safety issues still have to be addressed by further clinical trials.