The Pathophysiology of Post-Radical Prostatectomy Incontinence: A Clinical and Video Urodynamic Study

Groutz, Asnat; Blaivas, Jerry G.; Chaikin, David C.; Weiss, Jeffrey P.; Verhaaren, Michael

doi:10.1016/s0022-5347(05)67538-6

Cited by 221 publications

(140 citation statements)

References 21 publications

Supporting

Mentioning

133

Contrasting

Unclassified

Order By: Relevance

“…Urodynamic studies of UI in patients following radical prostatectomy demonstrated sphincteric deficiency as the major or sole cause in approximately two thirds of patients. 43 Isolated bladder overactivity occurred in only 6%, but overactivity was associated with sphincter deficiency in one third of patients. An obstructed voiding pattern may be due to an outlet stricture (clinically relevant in only 6% of patients, usually located at the vesico-urethral anastomosis and occasionally in the more distal urethra) or to impaired detrusor contractility resulting from operative neurological injury and fibrosis.…”

Section: Assessment Of Urinary Incontinencementioning

confidence: 99%

Urinary Incontinence following Treatment of Localized Prostate Cancer

Grise

Thurman

2001

Cancer Control

View full text Add to dashboard Cite

show abstract

Section: Assessment Of Urinary Incontinencementioning

confidence: 99%

Urinary Incontinence following Treatment of Localized Prostate Cancer

Grise

Thurman

2001

Cancer Control

View full text Add to dashboard Cite

show abstract

“…Nonetheless, 95% of men with postprostatectomy urinary leakage to any degree tend to describe symptoms consistent with stress urinary incontinence (SUI) that are documented on urodynamic studies. [16,17] …”

Section: Etiologymentioning

confidence: 99%

“…Broadly, these include detrusor over-and underactivity, decreased vesical compliance, ISD, and bladder outlet obstruction, as in the case of anastomotic strictures. [16,50] The presence of these factors pre-operatively must also be considered. Most cases of incontinence are a result of intraoperative damage to the native urinary sphincteric mechanisms [11] , particularly the intrinsic sphincter component.…”

Section: Pathophysiologymentioning

confidence: 99%

“…Most cases of incontinence are a result of intraoperative damage to the native urinary sphincteric mechanisms [11] , particularly the intrinsic sphincter component. [16,50,51] Bladder denervation during prostatectomy is also a frequent cause of incontinence after the operation, resulting in impaired detrusor contractility and poor bladder compliance.…”

Section: Pathophysiologymentioning

confidence: 99%

See 1 more Smart Citation

Post-prostatectomy incontinence: Etiology, evaluation, and management

Singla

2014

Turkish Journal of Urology

View full text Add to dashboard Cite

Urinary incontinence after prostatectomy or radiation is a devastating problem in men and remains the most feared complication following the treatment of localized prostate cancer. With an increasing number of radical prostatectomies performed globally for prostate cancer, the impact of urinary incontinence on quality of life assumes an even greater importance. With the advent of male sling procedures, more men are now seeking treatment for incontinence. Since the introduction of the artificial urinary sphincter almost four decades ago, several surgical procedures have emerged to manage post-prostatectomy incontinence, including the male sling for milder forms of incontinence. Several of the newer procedures have shown promise in the United States; many others have been developed and utilized in other parts of the world, though they have not yet gained FDA approval in the United States. The present review seeks to illuminate the etiology, evaluation, and management of post-prostatectomy incontinence. An effort has been made to provide an algorithm to clinicians for appropriate surgical management. The surgical techniques of commonly performed procedures and their outcomes are described.

show abstract

“…Postoperative incontinence is a common side effect after prostatectomy that can severely impact quality of life [2 -6]. The pathophysiology of incontinence is largely due to extrinsic sphincter insufficiency; however may be exacerbated by various other factors [7].…”

Section: Introductionmentioning

confidence: 99%

Monocyte Chemotactic Protein-1 (MCP-1) as a Predictor of Prolonged Urinary Incontinence After Radical Prostatectomy

Liss¹,

Ahlering

Morales

et al. 2016

TOUNJ

View full text Add to dashboard Cite

Objectives:To investigate monocyte chemotactic protein-1 (MCP-1) as a novel urinary biomarker to predict prolonged post prostatectomy incontinence. Methods:Men submitted urine samples prior to robotic radical prostatectomy. MCP-1 values were derived using an ELISA test. Pad usage at 7, 30, and 60 days were documented by patient post cards mailed when zero pads was reached. The primary outcome was defined as no incontinence pad usage at 30 days at prostatectomy. Results:After exclusions, 76 patients were included in analyses. Continence was reached by 29% (22/76), 56% (42/76), and (75/76) 98% at 7, 30, and 60 days, respectively. The average MCP-1 (p=0.258) was not different between the continent and incontinent groups. Highest quartile of MCP-1 (MCP > 166 pg/mL) and normalized MCP-1 (MCP-1/TV >0.53) noted a significant delay in continence at 30 days (p=0.050 and p=0.003). Only 26% (5/19) in the highest MCP1/TV quartile were continent, whereas 65% (37/57) of men in the 3 lower quartiles reached zero pad continence (p=0.003). In a logistic regression model the highest quartile of MCP1/TV had a significant chance of being incontinent at 30 days (OR 0.22; 95% CI 0.058-0.80; p=0.022). Conclusion:MCP-1/TV is a urinary biomarker that may predict prolonged urinary incontinence after radical prostatectomy.

show abstract

The Pathophysiology of Post-Radical Prostatectomy Incontinence: A Clinical and Video Urodynamic Study

Abstract: Sphincteric incontinence is the most common urodynamic finding in patients with post-radical prostatectomy incontinence, although other findings may coexist. The most accurate diagnosis is attained when all objective measures are put in perspective with the clinical setting.

Cited by 221 publications

References 21 publications

Urinary Incontinence following Treatment of Localized Prostate Cancer

Urinary Incontinence following Treatment of Localized Prostate Cancer

Post-prostatectomy incontinence: Etiology, evaluation, and management

Monocyte Chemotactic Protein-1 (MCP-1) as a Predictor of Prolonged Urinary Incontinence After Radical Prostatectomy

Contact Info

Product

Resources

About