Making cancer support services sustainable in value-based care.

Bulking agents are used in the treatment of urinary stress incontinence associated with intrinsic sphincter deficiency. Bovine collagen remains the gold standard despite problems such as allergic reaction and absorption of the injected material. Several new products are being evaluated or used clinically to try and overcome problems linked with bovine collagen. The aim of this paper is to review the bulking agents available and to put in prospect use of these products with the recent progress made in the treatment of urinary stress incontinence. The gold standard treatment for intrinsic sphincter deficiency is suburethral autologous or synthetic suburethral slings. Bulking agents are indicated for multi-operated patients with urinary stress incontinence and intrinsic sphincter deficiency. Bladder neck hypermobility is not a contraindication.