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PRISMA Study flow diagram ‐ showing the flow of literature through the review process
Figuras y tablas -
Figure 1

PRISMA Study flow diagram ‐ showing the flow of literature through the review process

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Comparison 1 Urethral injection therapy versus no treatment, Outcome 1 Number not improved (worse or unchanged) within first year.
Figuras y tablas -
Analysis 1.1

Comparison 1 Urethral injection therapy versus no treatment, Outcome 1 Number not improved (worse or unchanged) within first year.

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Comparison 1 Urethral injection therapy versus no treatment, Outcome 2 Pad weight test.
Figuras y tablas -
Analysis 1.2

Comparison 1 Urethral injection therapy versus no treatment, Outcome 2 Pad weight test.

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Comparison 1 Urethral injection therapy versus no treatment, Outcome 3 Disease‐specific measures.
Figuras y tablas -
Analysis 1.3

Comparison 1 Urethral injection therapy versus no treatment, Outcome 3 Disease‐specific measures.

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Comparison 1 Urethral injection therapy versus no treatment, Outcome 4 Number of patients requiring more than 1 treatment to achieve maximum benefit.
Figuras y tablas -
Analysis 1.4

Comparison 1 Urethral injection therapy versus no treatment, Outcome 4 Number of patients requiring more than 1 treatment to achieve maximum benefit.

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Comparison 1 Urethral injection therapy versus no treatment, Outcome 5 Peri‐ and postoperative complication.
Figuras y tablas -
Analysis 1.5

Comparison 1 Urethral injection therapy versus no treatment, Outcome 5 Peri‐ and postoperative complication.

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Comparison 1 Urethral injection therapy versus no treatment, Outcome 6 Serious morbidity (such as pulmonary embolism) or mortality.
Figuras y tablas -
Analysis 1.6

Comparison 1 Urethral injection therapy versus no treatment, Outcome 6 Serious morbidity (such as pulmonary embolism) or mortality.

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Comparison 2 Urethral injection therapy versus conservative management, Outcome 1 Number not cured (worse, unchanged or improved) at 3 months.
Figuras y tablas -
Analysis 2.1

Comparison 2 Urethral injection therapy versus conservative management, Outcome 1 Number not cured (worse, unchanged or improved) at 3 months.

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Comparison 2 Urethral injection therapy versus conservative management, Outcome 2 Number not improved (worse or unchanged) at 3 months.
Figuras y tablas -
Analysis 2.2

Comparison 2 Urethral injection therapy versus conservative management, Outcome 2 Number not improved (worse or unchanged) at 3 months.

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Comparison 2 Urethral injection therapy versus conservative management, Outcome 3 Disease‐specific measures.
Figuras y tablas -
Analysis 2.3

Comparison 2 Urethral injection therapy versus conservative management, Outcome 3 Disease‐specific measures.

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Comparison 2 Urethral injection therapy versus conservative management, Outcome 4 Peri‐ and postoperative complication.
Figuras y tablas -
Analysis 2.4

Comparison 2 Urethral injection therapy versus conservative management, Outcome 4 Peri‐ and postoperative complication.

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Comparison 3 Urethral injection therapy versus other surgical managements, Outcome 1 Number not cured (subjectively) within first year.
Figuras y tablas -
Analysis 3.1

Comparison 3 Urethral injection therapy versus other surgical managements, Outcome 1 Number not cured (subjectively) within first year.

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Comparison 3 Urethral injection therapy versus other surgical managements, Outcome 2 Number not cured (objectively) within first year.
Figuras y tablas -
Analysis 3.2

Comparison 3 Urethral injection therapy versus other surgical managements, Outcome 2 Number not cured (objectively) within first year.

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Comparison 3 Urethral injection therapy versus other surgical managements, Outcome 3 Presence of urinary urgency and urge incontinence.
Figuras y tablas -
Analysis 3.3

Comparison 3 Urethral injection therapy versus other surgical managements, Outcome 3 Presence of urinary urgency and urge incontinence.

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Comparison 3 Urethral injection therapy versus other surgical managements, Outcome 4 Disease‐specific measures.
Figuras y tablas -
Analysis 3.4

Comparison 3 Urethral injection therapy versus other surgical managements, Outcome 4 Disease‐specific measures.

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Comparison 3 Urethral injection therapy versus other surgical managements, Outcome 5 Numbers not satisfied.
Figuras y tablas -
Analysis 3.5

Comparison 3 Urethral injection therapy versus other surgical managements, Outcome 5 Numbers not satisfied.

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Comparison 4 One material for injectable treatment versus another material for injectable treatment, Outcome 1 Number not cured (worse, unchanged ) within first year.
Figuras y tablas -
Analysis 4.1

Comparison 4 One material for injectable treatment versus another material for injectable treatment, Outcome 1 Number not cured (worse, unchanged ) within first year.

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Comparison 4 One material for injectable treatment versus another material for injectable treatment, Outcome 2 Number not cured (worse, unchanged ) after first year.
Figuras y tablas -
Analysis 4.2

Comparison 4 One material for injectable treatment versus another material for injectable treatment, Outcome 2 Number not cured (worse, unchanged ) after first year.

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Comparison 4 One material for injectable treatment versus another material for injectable treatment, Outcome 3 Number not improved (worse or unchanged) within first year.
Figuras y tablas -
Analysis 4.3

Comparison 4 One material for injectable treatment versus another material for injectable treatment, Outcome 3 Number not improved (worse or unchanged) within first year.

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Comparison 4 One material for injectable treatment versus another material for injectable treatment, Outcome 4 Number not improved (worse or unchanged) after first year.
Figuras y tablas -
Analysis 4.4

Comparison 4 One material for injectable treatment versus another material for injectable treatment, Outcome 4 Number not improved (worse or unchanged) after first year.

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Comparison 4 One material for injectable treatment versus another material for injectable treatment, Outcome 5 Presence of urge incontinence.
Figuras y tablas -
Analysis 4.5

Comparison 4 One material for injectable treatment versus another material for injectable treatment, Outcome 5 Presence of urge incontinence.

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Comparison 4 One material for injectable treatment versus another material for injectable treatment, Outcome 6 Pad weight test.
Figuras y tablas -
Analysis 4.6

Comparison 4 One material for injectable treatment versus another material for injectable treatment, Outcome 6 Pad weight test.

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Comparison 4 One material for injectable treatment versus another material for injectable treatment, Outcome 7 Number of treatment required to achieve maximum benefit.
Figuras y tablas -
Analysis 4.7

Comparison 4 One material for injectable treatment versus another material for injectable treatment, Outcome 7 Number of treatment required to achieve maximum benefit.

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Comparison 4 One material for injectable treatment versus another material for injectable treatment, Outcome 8 Number of patients requiring more than 1 treatment to achieve maximum benefit.
Figuras y tablas -
Analysis 4.8

Comparison 4 One material for injectable treatment versus another material for injectable treatment, Outcome 8 Number of patients requiring more than 1 treatment to achieve maximum benefit.

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Comparison 4 One material for injectable treatment versus another material for injectable treatment, Outcome 9 Total volume injected.
Figuras y tablas -
Analysis 4.9

Comparison 4 One material for injectable treatment versus another material for injectable treatment, Outcome 9 Total volume injected.

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Comparison 4 One material for injectable treatment versus another material for injectable treatment, Outcome 10 Peri‐ and post‐ operative complication.
Figuras y tablas -
Analysis 4.10

Comparison 4 One material for injectable treatment versus another material for injectable treatment, Outcome 10 Peri‐ and post‐ operative complication.

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Comparison 4 One material for injectable treatment versus another material for injectable treatment, Outcome 11 Voiding difficulties postoperatively and long‐term (hypercontinence).
Figuras y tablas -
Analysis 4.11

Comparison 4 One material for injectable treatment versus another material for injectable treatment, Outcome 11 Voiding difficulties postoperatively and long‐term (hypercontinence).

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Comparison 4 One material for injectable treatment versus another material for injectable treatment, Outcome 12 New urinary symptoms (urge incontinence).
Figuras y tablas -
Analysis 4.12

Comparison 4 One material for injectable treatment versus another material for injectable treatment, Outcome 12 New urinary symptoms (urge incontinence).

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Comparison 4 One material for injectable treatment versus another material for injectable treatment, Outcome 13 Injection site complications.
Figuras y tablas -
Analysis 4.13

Comparison 4 One material for injectable treatment versus another material for injectable treatment, Outcome 13 Injection site complications.

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Comparison 5 One route of injection versus another route of injection, Outcome 1 Number not cured (worse, unchanged or improved) within first year.
Figuras y tablas -
Analysis 5.1

Comparison 5 One route of injection versus another route of injection, Outcome 1 Number not cured (worse, unchanged or improved) within first year.

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Comparison 5 One route of injection versus another route of injection, Outcome 2 Urinary retention.
Figuras y tablas -
Analysis 5.2

Comparison 5 One route of injection versus another route of injection, Outcome 2 Urinary retention.

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Comparison 1. Urethral injection therapy versus no treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Number not improved (worse or unchanged) within first year Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

1.1 periurethral autologous fat vs saline

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 Pad weight test Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2.1 periurethral autologous fat vs saline

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 Disease‐specific measures Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3.1 periurethral autologous fat vs saline

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 Number of patients requiring more than 1 treatment to achieve maximum benefit Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

4.1 periurethral autologous fat vs saline

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

5 Peri‐ and postoperative complication Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

5.1 periurethral autologous fat vs saline

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 Serious morbidity (such as pulmonary embolism) or mortality Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

6.1 periurethral autologous fat vs saline

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]
Figuras y tablas -
Comparison 1. Urethral injection therapy versus no treatment
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Comparison 2. Urethral injection therapy versus conservative management

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Number not cured (worse, unchanged or improved) at 3 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

2 Number not improved (worse or unchanged) at 3 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

3 Disease‐specific measures Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

4 Peri‐ and postoperative complication Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

4.1 retention

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]
Figuras y tablas -
Comparison 2. Urethral injection therapy versus conservative management
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Comparison 3. Urethral injection therapy versus other surgical managements

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Number not cured (subjectively) within first year Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

1.1 macroplastique vs pubovaginal sling

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 Number not cured (objectively) within first year Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

2.1 collagen vs surgery

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.2 macroplastique vs pubovaginal sling

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 Presence of urinary urgency and urge incontinence Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

3.1 collagen vs surgery

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 Disease‐specific measures Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

4.1 collagen vs surgery

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5 Numbers not satisfied Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

5.1 collagen vs surgery

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.2 macroplastique vs pubovaginal sling

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]
Figuras y tablas -
Comparison 3. Urethral injection therapy versus other surgical managements
Ir a la tabla de la revisión
Comparison 4. One material for injectable treatment versus another material for injectable treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Number not cured (worse, unchanged ) within first year Show forest plot

5

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

1.1 carbon particles vs collagen

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 Silicone particles vs collagen

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.3 Ethylene vinyl alcohol copolymer vs collagen

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.4 Permacol vs silicone particles

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.5 Dextranomer/hyaluronic acid versus collagen <2g leakage on pad test

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 Number not cured (worse, unchanged ) after first year Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

2.1 Carbon particles versus collagen

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.2 CaHa versus collagen

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 Number not improved (worse or unchanged) within first year Show forest plot

3

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

3.1 silicone particles vs collagen

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.2 calcium hydroxylapatite versus collagen

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.3 Permacol vs silicone at 6 months using stamey grade

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.4 permacol vs silicone at 6 months using KCQ

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.5 Zuidex versus Contigen using 50% reduction in leak on provocation

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.6 Zuidex vs collagen improvement of one or more Stamey grade

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 Number not improved (worse or unchanged) after first year Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

4.1 Carbon particles versus collagen

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4.2 CaHa versus collagen ‐ improved

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4.3 CaHa versus collagen ‐ significant improvement

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

5 Presence of urge incontinence Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

5.1 Permacol vs silicone particles

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 Pad weight test Show forest plot

4

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

6.1 carbon particles vs collagen

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.2 CaHa versus collagen

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.3 Silicone particles vs collagen

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.4 Dexranomer/hyaluronic acid versus collagen

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

7 Number of treatment required to achieve maximum benefit Show forest plot

2

699

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.1 carbon particles vs collagen

1

355

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.2 Zuidex vs collagen

1

344

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

8 Number of patients requiring more than 1 treatment to achieve maximum benefit Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

8.1 silicone particles vs collagen

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

8.2 Zuidex versus collagen

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

9 Total volume injected Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

9.1 Silicon vs collagen

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

9.2 Zuidex vs collagen

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

10 Peri‐ and post‐ operative complication Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

10.1 CaHa particles vs collagen

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

10.2 Zuidex vs collagen

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

11 Voiding difficulties postoperatively and long‐term (hypercontinence) Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

11.1 CaHa versus collagen

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

11.2 permacol vs silicone particles

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

12 New urinary symptoms (urge incontinence) Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

12.1 CaHa vs collagen

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

13 Injection site complications Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

13.1 Zuidex versus collagen

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]
Figuras y tablas -
Comparison 4. One material for injectable treatment versus another material for injectable treatment
Ir a la tabla de la revisión
Comparison 5. One route of injection versus another route of injection

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Number not cured (worse, unchanged or improved) within first year Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

1.1 periurethral injection vs transurethral injection

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 bladder neck versus mid‐urethral

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 Urinary retention Show forest plot

2

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2.1 periurethral vs transurethral injection

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 bladder neck vs mid‐urethral

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]
Figuras y tablas -
Comparison 5. One route of injection versus another route of injection
Ir a la tabla de la revisión