Incontinence after radical prostatectomy: surgical treatment options

Stress urinary incontinence is an uncommon finding in healthy men. Following radical prostatectomy, however, stress urinary incontinence is the most important complication influencing patient morbidity following surgery and influencing satisfaction, regardless of the surgical technique applied. Conservative treatment options centre at early restoration of bladder and pelvic floor function. When significant and bothersome stress urinary incontinence persists, even after six to 12 months active treatment follow-up, surgical restoration of continence seems advisable.

Two themes emerge in reviewing the recent publications in this field. Implantation of the hydraulic artificial urinary sphincter is still the gold standard, particularly in severe cases. Alternatively, new techniques and other artificial materials are gaining favour, aiming at a large cohort of patients with less severe incontinence, which have been not treated or overtreated so far. Advances in both areas are covered within this review article in detail.

For treatment of incontinence following prostatectomy, a large variety of surgical techniques are readily available and have proven to be helpful tools in making patients' uncomfortable lives much easier. In addition, the wide armamentarium of artificial materials and techniques may help to choose the proper surgical technique for every patients' needs.