Assessing Polyacrylamide Hydrogel for Stress Urinary Incontinence: Failure Rates and Durability

A large-cohort evaluation of polyacrylamide hydrogel injections for stress urinary incontinence reports a 35.9% failure rate within two years, refining durability expectations for minimally invasive SUI care. That patient‑reported recurrence rate indicates a substantial minority will need further treatment within 24 months and therefore alters counseling and follow-up planning for patients choosing bulking strategies.

This retrospective observational review included 256 women treated for stress urinary incontinence, with primary endpoints of treatment failure, time-to-failure, and repeat interventions; the cohort uniformly received polyacrylamide hydrogel injections and was followed for at least two years. Baseline complexity and prior surgical history were captured and fed into multivariable models to seek predictors, and adverse events were recorded during routine clinical surveillance. The pragmatic design offers a real-world durability estimate that frames the reported outcomes.

35.9% of patients met the study definition of failure within two years, and the mean time to failure (9.1 months) clustered early within the two‑year window (SD 11.6 months). Repeat injection occurred in 12% of the cohort and 15% proceeded to other incontinence surgery—roughly one in eight patients received an additional bulking procedure and about one in seven moved to more definitive surgery.

Multivariable analysis did not identify patient- or procedure-level predictors of failure; the adjusted models were negative. By comparison, sling procedures frequently report lower mid‑term failure and reduced early reintervention in many series, while bulking agents as a class show variable durability.