Original Title: Sustancias de abultamiento para la incontinencia urinaria de esfuerzo en mujeres

Authors' recommendations: No studies comparing the use of bulking agents with polyacrylamide hydrogel versus surgery with pelvic mesh in women with stress urinary incontinence have been found. No studies comparing the use of hydrogel polyacrylamide with other bulking agents for this indication have been found either. Moderate-quality evidence obtained from randomized clinical trials shows that the use of a bulking agent with polyacrylamide hydrogel (Bulkamid®) in women with stress urinary incontinence when compared with retropubic sub-urethral sling surgery yields similar benefits. They both reduce urine leak and are associated to a better quality of life and sexual function, with low rates of adverse events. Patients undergoing this bulking technology may require another injection within the first three years, while those who choose the retropubic sling may require another intervention up to five years after the procedure. Clinical practice guidelines from the United States of America, Europe and the United Kingdom indicate that the first choice of treatment for female stress urinary incontinence is colposuspension (open or laparoscopic) or implantation of an autologous sub-urethral sling, depending on the incontinence urethral bulking agents (by cystoscopy) are another low-risk option although they report that their efficacy is lower than that of other surgical procedures and may require re-interventions. Coverage policies from the United Kingdom public health funders and the United States of America private health funders mention they cover the technology as a treatment alternative in patients not willing to undergo surgery. Coverage of this technology is not mentioned in Argentina or in the countries of the region surveyed. No economic evaluations carried out in Argentina or in other countries have been found; however, the economic impact of this technology is not considered favorable due to its high cost versus the cost of its comparator.

Project Status: Completed

Year Published: 2024

URL for published report: https://ets.iecs.org.ar/publication/2195

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Argentina

Organisation Name: Institute for Clinical Effectiveness and Health Policy

Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA

Contact Name: info@iecs.org.ar

Contact Email: info@iecs.org.ar

Copyright: <p>Institute for Clinical Effectiveness and Health Policy (IECS)</p>