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Further to your item 'Sugar for incontinence' (Coming Your Way, March 12), Zuidex is an injectable bulking agent for women with stress urinary incontinence.

The copolymer is injected into the mid-portion of the urethra under local anaesthetic in the office setting using a specialised implacer device. Trial data reported so far indicate efficacy similar to other injectables with a 60-70 per cent cure rate at 12 months. Long-term safety data are reassuring since the same compound has been used for the last 20 years for vesico-ureteric reflux in children.

Zuidex may be useful in the management of those women with recurrent stress urinary incontinence following previous surgery, those who are unable to tolerate a general anaesthetic and also in women who have not yet completed their family and are thus inappropriate for definitive surgery.

Mr Dudley Robinson

Consultant Urogynaecologist

Kings College Hospital

London SE5

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