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Pharmacological Treatment of Post-Prostatectomy Incontinence: What is the Evidence?

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Abstract

Urinary incontinence is a common and debilitating problem, and post-prostatectomy incontinence (PPI) is becoming an increasing problem, with a higher risk among elderly men. Current treatment options for PPI include pelvic floor muscle exercises and surgery. Conservative treatment has disputable effects, and surgical treatment is expensive, is not always effective, and may have complications. This article describes the prevalence and causes of PPI and the current treatment methods. We conducted a search of the PUBMED database and reviewed the current literature on novel medical treatments of PPI, with special focus on the aging man. Antimuscarinic drugs, phosphodiesterase inhibitors, duloxetine, and α-adrenergic drugs have been proposed as medical treatments for PPI. Most studies were small and used different criteria for quantifying incontinence and assessing treatment results. Thus, there is not enough evidence to recommend the use of these medications as standard treatment of PPI. To determine whether medical therapy is a viable option in the treatment of PPI, randomized, placebo-controlled studies are needed that also assess side effects in the elderly population.

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Acknowledgments

Ole Martin Løvvik has assisted with the bibliography, given technical support, and carefully read through the manuscript.

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Authors and Affiliations

  1. Department of Urology, Akershus University Hospital, Lørenskog, Norway

    Anja Løvvik & Stig Müller

  2. Institute of Clinical Medicine, University of Oslo, Oslo, Norway

    Stig Müller

  3. Department of Urology, University Hospital North Norway, PO Box.102, N-9038, Tromsø, Norway

    Hitendra R. H. Patel

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  1. Anja Løvvik
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Correspondence to Hitendra R. H. Patel.

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Anja Løvvik, Stig Müller and Hitendra Patel declare no conflicts of interest.

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Løvvik, A., Müller, S. & Patel, H.R.H. Pharmacological Treatment of Post-Prostatectomy Incontinence: What is the Evidence?. Drugs Aging 33, 535–544 (2016). https://doi.org/10.1007/s40266-016-0388-8

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