Kasi et al (2016) performed a systematic review on the effectiveness of polyacrylamide hydrogel (PAHG, Bulkamid) in the treatment of female patients with SUI with regard to reproducibility, feasibility, safety and clinical outcome. These investigators searched MEDLINE (1966 to 2015), Scopus (2004 to 2015), POPLINE (1974 to 2015) and ClinicalTrials.gov (2008 to 2015) along with reference lists of electronically retrieved studies. Observational studies, prospective, retrospective and RCTs were included. Two reviewers independently selected studies, assessed the risk of bias and tabulated data to structured forms. These researchers included 8 studies, which enrolled a total of 767 patients who received treatment with PAHG. They found that 186 of 767 women (24.3 %, range of 12 to 35 %) required re-injection in order to achieve adequate effectiveness. The most frequent adverse effects were pain at the site of injection (4 to 14 %) and urinary tract infections (3 to 7 %). Both the number of incontinence episodes/24 hours and the number of ml/24 hours were significantly reduced 1 year following treatment and the quality of life of patients was significantly improved. The authors concluded that PAHG is a safe intervention for treating women with SUI, but repeat injections are often required. They stated that further research is needed to compare its effectiveness with other bulking agents.