de Vries Allert M, Wadhwa Harpreet, Huang Jason, Farag Fawzy, Heesakkers John P F A, Kocjancic Ervin
Department of Urology, University of Illinois, Chicago, IL.
Department of Urology, Sohag University Hospital, Sohag, Egypt.
Female Pelvic Med Reconstr Surg. 2018 Nov/Dec;24(6):392-398. doi: 10.1097/SPV.0000000000000495.
Stress urinary incontinence in women is a common problem that significantly impacts quality of life. Periurethral injection of urethral bulking agents (UBAs) is a simple, noninvasive, and cost-effective treatment. However, complications associated with UBA are often underappreciated. Objective of this review was to get a complete overview of all published complications of UBA.
An extensive search of the scientific literature was conducted to quantitatively summarize the complications and their treatments of 8 UBAs. A total of 117 articles (original articles and case reports) were included in the final analysis. Complication incidence, treatment incidence, and follow-up time were extracted when mentioned. Statistical analysis of complication incidence of each UBA was calculated if possible.
A total of 2095 complications in 6462 treated patients were reported in 79 studies. Sixty-seven (3%) were considered serious implying operative correction (Clavien grade III); of these, 46 (69%) required incision and drainage, and 21 (31%) required a more invasive procedure. In 38 case reports and small case series, 49 patients were treated for 110 complications. Of these 110 complications, 41 (37%) can be classified as Clavien grade III.
This extensive review shows that various UBAs have different complication rates, with certain UBAs being more prone to serious complications. Based on available publications, most UBAs have a good safety profile, with low complication rates. However, although the majority of UBA complications are transient and require no or noninvasive treatment, serious complications may require invasive intervention and treatment.
女性压力性尿失禁是一个常见问题，严重影响生活质量。尿道周围注射尿道填充剂（UBAs）是一种简单、无创且经济有效的治疗方法。然而，与尿道填充剂相关的并发症常常未得到充分认识。本综述的目的是全面概述已发表的关于尿道填充剂的所有并发症。
广泛检索科学文献，以定量总结8种尿道填充剂的并发症及其治疗方法。最终分析纳入了总共117篇文章（原创文章和病例报告）。如有提及，提取并发症发生率、治疗发生率和随访时间。若可能，计算每种尿道填充剂并发症发生率的统计分析。
79项研究报告了6462例接受治疗患者中的2095例并发症。67例（3%）被认为是严重的，意味着需要手术矫正（Clavien III级）；其中，46例（69%）需要切开引流，21例（31%）需要更具侵入性的手术。在38篇病例报告和小病例系列中，49例患者因110例并发症接受治疗。在这110例并发症中，41例（37%）可归类为Clavien III级。
这项全面综述表明，各种尿道填充剂有不同的并发症发生率，某些尿道填充剂更容易出现严重并发症。根据现有出版物，大多数尿道填充剂具有良好的安全性，并发症发生率低。然而，尽管大多数尿道填充剂并发症是短暂的，无需或仅需无创治疗，但严重并发症可能需要侵入性干预和治疗。
