Worldwide there has been controversy regarding surgical management of stress urinary incontinence (SUI) in women. These concerns have been raised about the possibility that surgical management of SUI in women of advanced age can lead to a variety of postoperative side effects. Moreover, there were court actions in the UK, the USA, Canada, and European countries against vaginal slings and tapes.1,2 The US Food and Drug Administration (FDA) published recommendations for health care providers who treat SUI, in which it was emphasized that practitioners should obtain specialized training in each SUI surgical technique that they employ.3 The FDA also proposed special controls and follow-up with the patient submitting a voluntary report about any problems that occur. These safety concerns have contributed to increased rates of alternative treatment – the injection of urethral bulking agents. However, there are still limited data regarding the effectiveness and safety of this novel remedy for patients with SUI.

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