Surgery for stress urinary incontinence due to presumed sphincter deficiency after prostate surgery

Abstract

BackgroundIncontinence a er prostatectomy for benign or malignant disease is a well-known and o en a feared outcome. Although small degrees of incidental incontinence may go virtually unnoticed, larger degrees of incontinence can have a major impact on a man's quality of life.Conceptually, post-prostatectomy incontinence may be caused by sphincter malfunction or bladder dysfunction, or both. Most men with post-prostatectomy incontinence (60% to 100%) have stress urinary incontinence, which is involuntary urinary leakage on e ort or exertion, or on sneezing or coughing. This may be due to intrinsic sphincter deficiency and may be treated with surgery for optimal management of incontinence. Detrusor dysfunction is more common a er surgery for benign prostatic disease. ObjectivesTo determine the e ects of surgical treatment for urinary incontinence related to presumed sphincter deficiency a er prostate surgery for:-men with lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) -transurethral resection of prostate (TURP), photo vaporisation of the prostate, laser enucleation of the prostate or open prostatectomy -and -men with prostate cancer -radical prostatectomy (retropubic, perineal, laparoscopic, or robotic). Search methodsWe searched the Cochrane Incontinence Group Specialised Register, which contains trials identified from Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, MEDLINE in process, ClinicalTrials.gov, and handsearching of journals and conference proceedings (searched

Developing a rehabilitation programme for male urinary incontinence: detailed schemes and results on 122 patients

“…Patients with severe incontinence are likely to need surgery (e.g. artificial sphincter implantation) more than rehabilitation (Silva et al , ). The difference in the ages between the two groups might play a role in the success of the programme, as ageing is associated with decreased muscular performance and leakages (Knight, ); in our sample, patients who obtained rehabilitation had significantly lower median age.…”

Outcome and complications of adjustable continence therapy (ProACTTM) in the treatment of urinary incontinence after transurethral resection of the prostate: A multicenter study

“…Urinary incontinence after prostate surgery can significantly alter a person's quality of life . In cases of male SUI secondary to sphincter deficiency, conservative treatment may be tried for periods up to 6 to 12 months in advance of a surgical treatment .…”

“…Urinary incontinence after prostate surgery can significantly alter a person's quality of life . In cases of male SUI secondary to sphincter deficiency, conservative treatment may be tried for periods up to 6 to 12 months in advance of a surgical treatment . When conservative treatment fails, several surgical implants are available, such as the artificial urinary sphincter, male sling, and adjustable continence balloons .…”

Efficacy and safety of artificial urinary sphincter (AUS): Results of a large multi‐institutional cohort of patients with mid‐term follow‐up

“…The European Association of Urology (EAU) Guidelines for Urinary Incontinence still considers AUS implantation the standard treatment for moderate‐to‐severe SUI in men . This recommendation, however, is based on systematic reviews without high quality evidence (level 2b‐3), except for one small randomized clinical trial comparing AUS with bulking agents …”