{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T18:42:26Z","timestamp":1789756946788,"version":"4.0.1"},"reference-count":12,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Urology"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec><jats:title>Aims:<\/jats:title><jats:p> To analyze the outcomes of urethral re-bulking in the treatment of female stress urinary incontinence. <\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods:<\/jats:title><jats:p> We performed a multicenter observational retrospective study, which included all consecutive patients treated with urethral re-bulking for the treatment of persistent stress or mixed urinary incontinence after a previous urethral bulking. Objective outcomes were evaluated with the 24 h pad-test, while PGI-I questionnaires were administered to evaluate subjective outcomes. Clinical outcomes were assessed before re-bulking procedure and at last follow-up. Mann\u2013Whitney\u2019s U test was used for subgroup analysis. Shapiro-Wilk\u2019s tests were used as normality tests. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> In total, 62 patients who underwent urethral re-bulking between 2013 and 2020 in a multicenter setting were included. Most patients did not reach complete continence after the first procedure (n\u2009=\u200956) while the remainder reported recurrence of urinary incontinence after initial benefit. Median age at surgery was 66 (IQR: 55-73). Median overall follow-up was 30\u2009months (IQR: 24-41). Median time occurred between the first procedure and reintervention was 12\u2009months (IQR: 7-27). Bulking agents for the re-bulking procedures were bulkamid(n\u2009=\u200956), macroplastique(n\u2009=\u20094), and Prolastic(n\u2009=\u20092). A statistically significant reduction of median 24 h pad test from 100 g(IQR: 40-200) to 35 g(IQR: 0-120) was observed (p\u2009=\u20090.003). Dry rate after rebulking was 36.6%, while 85.4% patients declared themselves \u2018very much improved\u2019 or \u2018much improved\u2019 (PGI-I 1-2). Very few low-grade complications were observed (n\u2009=\u20094). A single case of major complication occurred. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p> Urethral re-bulking can be an effective technique for the treatment of stress urinary incontinence refractory to a previous urethral bulking and can determine a cumulative benefit after the first procedure. <\/jats:p><\/jats:sec>","DOI":"10.1177\/17562872211069265","type":"journal-article","created":{"date-parts":[[2022,1,18]],"date-time":"2022-01-18T08:02:26Z","timestamp":1642492946000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Can urethral re-bulking improve the outcomes of a prior urethral bulking?"],"prefix":"10.1177","volume":"14","author":[{"given":"Alessandro","family":"Giamm\u00f2","sequence":"first","affiliation":[{"name":"SC Neuro-Urologia, Spinal Cord Unit\/CTO, Citt\u00e0 della Salute e della Scienza di Torino, Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9162-8845","authenticated-orcid":false,"given":"Enrico","family":"Ammirati","sequence":"additional","affiliation":[{"name":"Neuro-Urology Department, CTO-Spinal Cord Unit, Citt\u00e0 della Salute e della Scienza di Torino, Via Zuretti 24, 10126 Torino, TO, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Geretto","sequence":"additional","affiliation":[{"name":"SC Neuro-Urologia, Spinal Cord Unit\/CTO, Citt\u00e0 della Salute e della Scienza di Torino, Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Manassero","sequence":"additional","affiliation":[{"name":"SC Neuro-Urologia, Spinal Cord Unit\/CTO, Citt\u00e0 della Salute e della Scienza di Torino, Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisella","family":"Squintone","sequence":"additional","affiliation":[{"name":"SC Neuro-Urologia, Spinal Cord Unit\/CTO, Citt\u00e0 della Salute e della Scienza di Torino, Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Falcone","sequence":"additional","affiliation":[{"name":"SC Neuro-Urologia, Spinal Cord Unit\/CTO, Citt\u00e0 della Salute e della Scienza di Torino, Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Del Popolo","sequence":"additional","affiliation":[{"name":"SOD of Neuro-Urology, Careggi University Hospital, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donatella","family":"Pistolesi","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Translational Research and New Technologies, University of Pisa, Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oreste","family":"Risi","sequence":"additional","affiliation":[{"name":"SSD Urodinamica, ASST Bergamo Ovest, Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Costantini","sequence":"additional","affiliation":[{"name":"Andrology and Urogynecology Clinic, Santa Maria Terni Hospital, University of Perugia, Terni, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Giannantoni","sequence":"additional","affiliation":[{"name":"Functional and Surgical Urology Unit, Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3050-8748","authenticated-orcid":false,"given":"Vito","family":"Mancini","sequence":"additional","affiliation":[{"name":"Department of Urology and Organ Transplantation, University of Foggia, Policlinico Riuniti, Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6328-7980","authenticated-orcid":false,"given":"Vincenzo","family":"Li Marzi","sequence":"additional","affiliation":[{"name":"Urology Clinic, Careggi Hospital, University of Florence, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0308-8824","authenticated-orcid":false,"given":"Enrico Finazzi","family":"Agr\u00f2","sequence":"additional","affiliation":[{"name":"Urology Clinic, Tor Vergata University of Rome, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Pastorello","sequence":"additional","affiliation":[{"name":"Department of Urology, \u2018Sacro Cuore-Don Calabria\u2019 Hospital, Negrar, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Musco","sequence":"additional","affiliation":[{"name":"SOD of Neuro-Urology, Careggi University Hospital, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Gontero","sequence":"additional","affiliation":[{"name":"SC Neuro-Urologia, Spinal Cord Unit\/CTO, Citt\u00e0 della Salute e della Scienza di Torino, Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,1,18]]},"reference":[{"key":"bibr1-17562872211069265","doi-asserted-by":"publisher","DOI":"10.1111\/bju.14550"},{"key":"bibr2-17562872211069265","doi-asserted-by":"publisher","DOI":"10.1002\/nau.24388"},{"key":"bibr3-17562872211069265","first-page":"1","volume":"2017","author":"Kirchin V","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr4-17562872211069265","unstructured":"Considerations about surgical mesh for SUI, https:\/\/www.fda.gov\/medical-devices\/urogynecologic-surgical-mesh-implants\/considerations-about-surgical-mesh-sui (accessed 3 August 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