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Injectable bulking agents (IBA) have been used with varying success for the treatment of faecal incontinence. A systematic review to assess the safety and efficacy of IBAs was performed.Thirty seven publications were identified and studied. The following variables were pooled for univariate analysis: type, location, route and quantity of IBAs, use of ultrasound guidance, antibiotics, laxatives and anaesthetics. Predictors for the development of complications (infection, ulceration, and/or early explantation) and successful outcomes (improvement in incontinence) were identified with multivariate logistic regression analysis. Odds ratios and 95% confidence intervals were calculated, a P-value of < 0.05 was significant.A total of 1028 patients were included for analysis. On multivariate analysis, three variables were found to bepredictors for the development of postoperative complications: type [OR 1.9 (95% CI 1.3-3.8), P = 0.02], location [OR 2.3 (95% CI 1.1-5.8), P = 0.01] of IBAs and route [5.1 (95% CI 3.1-12.3), P = 0.01] of administration. Two variables werepredictors for a successful outcome: location [OR 2.7 (95% CI 1.2-4.9), P = 0.03] of IBAs and use of postoperative antibiotics [OR 1.4 (95% CI 1.3-1.6), P = 0.01].Our systematic review has identified variations in thepractices of IBAs which appear to influence the likelihood of complications and affect the outcomes after treatment.