{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T19:51:37Z","timestamp":1782935497748,"version":"3.54.5"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"\n Introduction:<\/jats:title>\n Polyacrylamide hydrogel (PAHG) injection is a minimally invasive treatment option for female stress incontinence, but reported effectiveness and durability vary across studies. This study aims to evaluate the effectiveness, safety, and retreatment rates of PAHG injection for female SUI through a systematic review and meta-analysis.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n A systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines and registered in PROSPERO (CRD420261328968). Literature was retrieved from electronic databases, such as PubMed, ProQuest, EuroPMC, and EBSCO, from database inception through February 2026. Cohort studies assessing PAHG injection for SUI were systematically reviewed. Random-effects models were used, heterogeneity was assessed with\n I<\/jats:italic>\n 2<\/jats:sup>\n , and meta-regression examined age and follow-up as moderators. Publication bias was evaluated using funnel plots and Egger\u2019s test.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Thirteen studies, including 1797 patients, were analyzed. The pooled responder rate was 72% (95% confidence interval [CI] 64%\u201378%;\n I<\/jats:italic>\n 2<\/jats:sup>\n = 87%). A greater mean age was significantly associated with higher response rates (\n P<\/jats:italic>\n = 0.04). Four studies reporting International Consultation on Incontinence Questionnaire outcomes demonstrated a pooled mean reduction of \u22126.65 points (95% CI: \u22128.52 to \u22124.78;\n I<\/jats:italic>\n 2<\/jats:sup>\n = 92.8%). The pooled repeat injection rate was 16% (95% CI: 10%\u201327%;\n I<\/jats:italic>\n 2<\/jats:sup>\n = 94%). Follow-up duration did not significantly influence retreatment rates (\n P<\/jats:italic>\n = 0.85). No evidence of publication bias was detected for the primary outcome (\n P<\/jats:italic>\n = 0.96).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n PAHG injection is a minimally invasive treatment associated with clinically meaningful symptom improvement and a favorable safety profile in women with SUI. However, given the single-arm design of the included studies and substantial heterogeneity, these findings should be interpreted with caution.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/iju.iju_151_26","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T07:26:01Z","timestamp":1782890761000},"page":"190-199","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness and safety of polyacrylamide hydrogel injection for female stress urinary incontinence: A systematic review and single-arm meta-analysis"],"prefix":"10.4103","volume":"42","author":[{"given":"Hendri","family":"Tanjaya","sequence":"first","affiliation":[{"name":"School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amaditta","family":"Jericka","sequence":"additional","affiliation":[{"name":"School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mutiara","family":"Riani","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Budi","family":"Darmawan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edihan","family":"Mardjuki","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Uriah","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik Noverdian","family":"Suryadi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"R1-20260701","doi-asserted-by":"crossref","first-page":"5","DOI":"10.3390\/medicina59010005","article-title":"The anatomical pathogenesis of stress urinary incontinence in women","volume":"59","author":"Yang","year":"2022","journal-title":"Medicina (Kaunas)"},{"key":"R2-20260701","first-page":"CD009508","article-title":"Comparisons of approaches to pelvic floor muscle training for urinary incontinence in women","volume":"12","author":"Hay-Smith","year":"2024","journal-title":"Cochrane Database Syst Rev"},{"key":"R3-20260701","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/s12916-017-0828-2","article-title":"Can incontinence be cured? A systematic review of cure rates","volume":"15","author":"Riemsma","year":"2017","journal-title":"BMC Med"},{"key":"R4-20260701","doi-asserted-by":"crossref","first-page":"101713","DOI":"10.1016\/j.cont.2024.101713","article-title":"Complications associated with the use of mesh to treat female urinary incontinence and pelvic organ prolapse","volume":"12","author":"Welk","year":"2024","journal-title":"Continence"},{"key":"R5-20260701","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1016\/j.eururo.2017.04.026","article-title":"Updated systematic review and meta-analysis of the comparative data on colposuspensions, pubovaginal slings, and midurethral tapes in the surgical treatment of female stress urinary incontinence","volume":"72","author":"Fusco","year":"2017","journal-title":"Eur Urol"},{"key":"R6-20260701","doi-asserted-by":"crossref","first-page":"101219","DOI":"10.1016\/j.cont.2024.101219","article-title":"Mid- to long-term results of polyacrylamide hydrogel (Bulkamid\u00ae) as recourse for female stress urinary incontinence","volume":"10","author":"Osse","year":"2024","journal-title":"Continence"},{"key":"R7-20260701","doi-asserted-by":"crossref","first-page":"2977","DOI":"10.1007\/s00192-023-05626-x","article-title":"Quality of life and sexual function after tension-free vaginal tape and polyacrylamide hydrogel injection for primary stress urinary incontinence: 3-year follow-up from a randomized clinical trial","volume":"34","author":"Itkonen Freitas","year":"2023","journal-title":"Int Urogynecol J"},{"key":"R8-20260701","doi-asserted-by":"crossref","first-page":"775","DOI":"10.3390\/medicina58060775","article-title":"Up-to-date procedures in female stress urinary incontinence surgery: A concise review on bulking agents procedures","volume":"58","author":"Serati","year":"2022","journal-title":"Medicina (Kaunas)"},{"key":"R9-20260701","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1007\/s00192-018-3644-0","article-title":"Patients\u2019 perspectives on urethral bulk injection therapy and mid-urethral sling surgery for stress urinary incontinence","volume":"29","author":"Casteleijn","year":"2018","journal-title":"Int Urogynecol J"},{"key":"R10-20260701","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1007\/s00192-015-2781-y","article-title":"Polyacrylamide hydrogel (Bulkamid\u00ae) for stress urinary incontinence in women: A systematic review of the literature","volume":"27","author":"Kasi","year":"2016","journal-title":"Int Urogynecol J"},{"key":"R11-20260701","doi-asserted-by":"crossref","DOI":"10.1007\/s00192-025-06473-8","article-title":"Failure rate, time to failure, and associated risk factors: Polyacrylamide hydrogel injection for the treatment of stress urinary incontinence in a large cohort","author":"Kelly","year":"2025","journal-title":"Int Urogynecol J"},{"key":"R14-20260701","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1186\/1471-2288-14-135","article-title":"Estimating the sample mean and standard deviation from the sample size, median, range and\/or interquartile range","volume":"14","author":"Wan","year":"2014","journal-title":"BMC Med Res Methodol"},{"key":"R16-20260701","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1111\/j.1464-410X.2006.06205.x","article-title":"A new bulking agent (polyacrylamide hydrogel) for treating stress urinary incontinence in women","volume":"98","author":"Lose","year":"2006","journal-title":"BJU Int"},{"key":"R17-20260701","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1007\/s00192-010-1214-1","article-title":"An open multicenter study of polyacrylamide hydrogel (Bulkamid\u00ae) for female stress and mixed urinary incontinence","volume":"21","author":"Lose","year":"2010","journal-title":"Int Urogynecol J"},{"key":"R18-20260701","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.ejogrb.2014.03.033","article-title":"Transurethral injection of polyacrylamide hydrogel (Bulkamid(\u00ae)) for the treatment of female stress or mixed urinary incontinence","volume":"178","author":"Martan","year":"2014","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"R19-20260701","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1590\/S1677-5538.IBJU.2014.01.06","article-title":"Polyacrylamide hydrogel (bulkamid\u00ae) in female patients of 80 or more years with urinary incontinence","volume":"40","author":"Vecchioli-Scaldazza","year":"2014","journal-title":"Int Braz J Urol"},{"key":"R20-20260701","first-page":"428","article-title":"Durability, safety and efficacy of polyacrylamide hydrogel (Bulkamid(\u00ae)) in the management of stress and mixed urinary incontinence: Three year follow up outcomes","volume":"68","author":"Pai","year":"2015","journal-title":"Cent European J Urol"},{"key":"R21-20260701","doi-asserted-by":"crossref","first-page":"1657","DOI":"10.1007\/s00192-017-3332-5","article-title":"Bulkamid (PAHG) in mixed urinary incontinence: What is the outcome?","volume":"28","author":"Mohr","year":"2017","journal-title":"Int Urogynecol J"},{"key":"R22-20260701","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1002\/nau.24589","article-title":"Seven-year efficacy and safety outcomes of Bulkamid for the treatment of stress urinary incontinence","volume":"40","author":"Brosche","year":"2021","journal-title":"Neurourol Urodyn"},{"key":"R23-20260701","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.3390\/jcm11061569","article-title":"Urethral bulking in the treatment of stress and mixed female urinary incontinence: Results from a multicenter cohort and predictors of clinical outcomes","volume":"11","author":"Giamm\u00f2","year":"2022","journal-title":"J Clin Med"},{"key":"R24-20260701","doi-asserted-by":"crossref","first-page":"334","DOI":"10.4274\/jus.galenos.2023.2023-5-3","article-title":"Minimally invasive treatment of female stress urinary incontinence with polyacrylamide hydrogel (Bulkamid\u00ae): Outcomes of a contemporary Turkish cohort including cases with mixed urinary incontinence and previously failed prior surgery","volume":"10","author":"K\u00f6seo\u011flu","year":"2023","journal-title":"J Urol Surg"},{"key":"R25-20260701","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1007\/s00345-024-05221-9","article-title":"One-year outcomes of polyacrylamide hydrogel (Bulkamid) injection in women with stress and mixed urinary incontinence","volume":"42","author":"Uleri","year":"2024","journal-title":"World J Urol"},{"key":"R26-20260701","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.urology.2024.11.032","article-title":"Outpatient periurethral injections of polyacrylamide hydrogel (Bulkamid) under local anesthesia in the office: A prospective single-center series","volume":"198","author":"Faurie","year":"2024","journal-title":"Urology"},{"key":"R27-20260701","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1007\/s00192-024-06005-w","article-title":"Effectiveness and safety profile of urethral bulking with Bulkamid(\u00ae) for stress urinary incontinence: A French multi-center cohort study","volume":"36","author":"Lamblin","year":"2025","journal-title":"Int Urogynecol J"},{"key":"R28-20260701","doi-asserted-by":"crossref","first-page":"103088","DOI":"10.1016\/j.fjurol.2026.103088","article-title":"Three-year efficacy of the urethral bulking agent BULKAMID\u00ae\u2122 for treatment of stress or mixed urinary incontinence: A bi-center retrospective study","volume":"36","author":"Huteau","year":"2026","journal-title":"Fr J Urol"},{"key":"R29-20260701","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta23140","article-title":"Surgical treatments for women with stress urinary incontinence: The ESTER systematic review and economic evaluation","volume":"23","author":"Brazzelli","year":"2019","journal-title":"Health Technol Assess"},{"key":"R30-20260701","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1016\/j.cger.2015.06.006","article-title":"Outcomes of surgery for stress urinary incontinence in the older woman","volume":"31","author":"Ellington","year":"2015","journal-title":"Clin Geriatr Med"},{"key":"R31-20260701","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1007\/s00192-019-04171-w","article-title":"Outcomes and failure risks in mid-urethral sling insertion in elderly and old age with urodynamic stress incontinence","volume":"31","author":"Lo","year":"2020","journal-title":"Int Urogynecol J"},{"key":"R32-20260701","first-page":"e37773","article-title":"Single incision mini-sling versus mid-urethral sling (transobturator\/retropubic) in females with stress urinary incontinence: A systematic review and meta-analysis","volume":"15","author":"Patel","year":"2023","journal-title":"Cureus"},{"key":"R33-20260701","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1007\/s00192-019-04202-6","article-title":"Voice your choice: A study of women\u2019s choice of surgery for primary stress urinary incontinence","volume":"31","author":"Dwyer","year":"2020","journal-title":"Int Urogynecol J"},{"key":"R34-20260701","doi-asserted-by":"crossref","first-page":"1659","DOI":"10.1001\/jama.2018.14997","article-title":"Long-term rate of mesh sling removal following midurethral mesh sling insertion among women with stress urinary incontinence","volume":"320","author":"Gurol-Urganci","year":"2018","journal-title":"JAMA"},{"key":"R35-20260701","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.urology.2022.03.033","article-title":"Mortality and reoperation following midurethral sling versus urethral bulking in older women","volume":"165","author":"Cadish","year":"2022","journal-title":"Urology"},{"key":"R36-20260701","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.3390\/jcm13051377","article-title":"Current treatment of stress urinary incontinence by bulking agents and laser therapy-an update","volume":"13","author":"Sikora","year":"2024","journal-title":"J Clin Med"}],"container-title":["Indian Journal of Urology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.4103\/iju.iju_151_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T18:10:16Z","timestamp":1782929416000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.4103\/iju.iju_151_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,30]]},"references-count":33,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/iju.iju_151_26","relation":{},"ISSN":["0970-1591","1998-3824"],"issn-type":[{"value":"0970-1591","type":"print"},{"value":"1998-3824","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,30]]},"assertion":[{"value":"2026-03-14","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-07","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}