Incontinence after radical prostatectomy: pathophysiology and management

Area of Science:

• Urology
• Surgical Oncology

Background:

• Radical prostatectomy can lead to urinary incontinence, impacting patient quality of life.
• Improvements in surgical techniques aim to preserve the urethral sphincteric mechanism, but incontinence persists in many cases.
• Post-prostatectomy incontinence often involves stress incontinence due to intrinsic sphincter deficiency and may coexist with bladder dysfunction.

Purpose of the Study:

• To review the management of urinary incontinence following radical prostatectomy.
• To highlight the efficacy of various treatment options for post-prostatectomy stress incontinence.

Main Methods:

• Review of current literature on post-prostatectomy incontinence.
• Discussion of treatment modalities including artificial urinary sphincters, collagen injections, and male urethral slings.

Main Results:

• Stress incontinence secondary to intrinsic sphincter deficiency is the most common type after radical prostatectomy.
• The artificial urinary sphincter is considered the treatment of choice for this condition.
• Collagen injection therapy and male bulbourethral slings are alternative treatment options.

Conclusions:

• Urinary incontinence remains a significant concern after radical prostatectomy.
• The artificial urinary sphincter offers a reliable solution for intrinsic sphincter deficiency.
• Alternative treatments should be considered based on individual patient factors and severity of incontinence.