Urinary incontinence after radical prostatectomy

Despite improvements in knowledge and technique, a growing number of patients experience incontinence after radical prostatectomy. This may be the result of damage to sphincteric structures, bladder dysfunction, an obstructive stricture, or some combination of these. After an appropriate interval to allow for improvement, the patient should undergo a thorough evaluation to assess the contribution of the various causes and should then be managed using a sequential treatment approach. Following restoration of adequate emptying, bladder dysfunction should be controlled first, if present, and persistent stress incontinence should then be managed according to its severity. Many patients with significant persistent incontinence after radical prostatectomy will need to consider placement of an artificial urinary sphincter.