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Urodynamics for postprostatectomy incontinence: when are they helpful and how do we use them?
Ying H Jura1, Craig V Comiter1
1Department of Urology, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305, USA.
The Urologic Clinics of North America
|July 27, 2014
Summary
Urodynamics helps evaluate postprostatectomy incontinence, guiding treatment choices. Key findings like detrusor underactivity impact management decisions for better outcomes.
Area of Science:
- Urology
- Urologic Surgery
Background:
- Postprostatectomy incontinence is a common complication following prostate cancer treatment.
- Treatment decisions for this condition can be complex, influenced by severity and prior interventions.
Purpose of the Study:
- To define the role of urodynamics in evaluating postprostatectomy incontinence.
- To identify specific clinical scenarios where urodynamics is indicated or contraindicated.
Main Methods:
- Review of clinical guidelines and evidence regarding urodynamic testing in postprostatectomy incontinence.
- Analysis of factors influencing treatment selection, including artificial urinary sphincter and male sling placement.
Main Results:
- Urodynamics is recommended for evaluating postprostatectomy incontinence, except in specific cases favoring artificial urinary sphincter placement.
- Indications include severe incontinence, prior radiation, or failed previous treatments like male slings.
- Urodynamic findings such as detrusor underactivity, overactivity, and reduced compliance are crucial for treatment planning.
Conclusions:
- Urodynamic evaluation should be reserved for cases where it can significantly alter treatment strategy or prognosis.
- Understanding urodynamic parameters is essential for optimizing the management of postprostatectomy incontinence.
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