The management of stress urinary incontinence after radical prostatectomy
- 24 June 2002
- journal article
- research article
- Published by Wiley in BJU International
- Vol. 90 (2), 155-161
- https://doi.org/10.1046/j.1464-410x.2002.02824.x
Abstract
Up to 30% of patients complain about urine leakage after radical prostatectomy, but persistent stress incontinence (beyond 1 year) affects <5% of them. This complication is mainly caused by sphincter dysfunction. Some preventive measures have been described to decrease the risk of incontinence after radical prostatectomy, but with conflicting results. The effectiveness of preoperative and early postoperative physiotherapy is controversial. Moreover, while meticulous apical dissection of the prostate significantly improves postoperative continence, the benefit of other surgical techniques, e.g. preserving the bladder neck and the neurovascular bundles, is under debate. The treatment of persistent stress urinary incontinence is mainly based on surgery, as this type of incontinence usually does not respond to physiotherapy and anticholinergic medication. While injection therapy is safe and well tolerated, its effect on postoperative continence is limited and decreases with time. The best results are achieved by implanting an artificial urinary sphincter, but with significant complication and revision rates.Keywords
This publication has 44 references indexed in Scilit:
- Heilbronn Laparoscopic Radical ProstatectomyEuropean Urology, 2001
- EVIDENCE OF TRIGONAL DENERVATION AND REINNERVATION AFTER RADICAL RETROPUBIC PROSTATECTOMYJournal of Urology, 2001
- EARLY POST-PROSTATECTOMY PELVIC FLOOR BIOFEEDBACKJournal of Urology, 2000
- The artificial urinary sphincter in men incontinent after radical prostatectomy: 5 year actuarial adequate function ratesBritish Journal of Urology, 1998
- Urodynamic Assessment of Urethral Sphincter Function In Post-Prostatectomy IncontinenceJournal of Urology, 1996
- Anterior bladder neck tube reconstruction at radical prostatectomy preserves functional urethral length — a comparative urodynamic studyBritish Journal of Urology, 1995
- Modified apical dissection for early continence after radical prostatectomyThe Prostate, 1993