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Urinary incontinence after radical prostatectomy
1Department of Urology, Indiana University, Indianapolis, USA.
Seminars in Urologic Oncology
|March 17, 2000
Summary
Post-prostatectomy incontinence affects many men. A structured evaluation and sequential treatment approach, addressing bladder issues first, can manage persistent symptoms, with artificial urinary sphincter placement as a potential solution.
Area of Science:
- Urology
- Surgical Oncology
Background:
- Radical prostatectomy, a treatment for prostate cancer, can lead to urinary incontinence.
- Despite surgical advancements, post-prostatectomy incontinence remains a significant concern for patients.
Purpose of the Study:
- To outline a systematic approach for evaluating and managing urinary incontinence after radical prostatectomy.
- To guide clinicians in addressing the multifactorial causes of post-prostatectomy incontinence.
Main Methods:
- Comprehensive patient evaluation to identify causes of incontinence, including sphincteric damage, bladder dysfunction, and strictures.
- Sequential treatment strategy prioritizing bladder emptying and dysfunction management.
- Assessment of incontinence severity for targeted interventions.
Main Results:
- A structured, sequential approach can effectively manage post-prostatectomy incontinence.
- Addressing bladder dysfunction before stress incontinence is crucial for optimal outcomes.
- Artificial urinary sphincter (AUS) implantation is a viable option for severe, persistent stress incontinence.
Conclusions:
- Effective management of post-prostatectomy incontinence requires a thorough, sequential evaluation and treatment plan.
- Early identification and management of contributing factors, such as bladder dysfunction, are key.
- Artificial urinary sphincter placement offers a solution for patients with refractory stress incontinence.