Incontinence after radical prostatectomy: Anything new in its management?

Authors

  • Romain Caremel
  • Jacques Corcos Department of Urology, Jewish General Hospital 3755 cote sainte catherine, Montreal, Quebec,Canada, H3T 1E2

DOI:

https://doi.org/10.5489/cuaj.1349

Keywords:

male urinary incontinence, prostatectomy, postoperative complications, review

Abstract

Introduction: With the increasing number of radical prostatectomies (RP) performed, male stress urinary incontinence (SUI) has become common. The artificial urinary sphincter (AUS) is the gold standard to treat SUI post-RP, but new devices have recently been developed. We review the recent studies on the treatment of SUI post-RP; we also describe the surgical techniques, mechanisms of action and results of these new procedures.

Methods: We conducted a literature review search in the PubMed/Medline and Embase databases. Our search was restricted to recent articles. We included studies even if the urinary incontinence was due to sphincter deficiency after RP in non-neurologic patients.

Results: We found 8 cohort studies for the surgical procedure: 3 studies concerning slings, 1 involving balloons adjustable implant, and 4 involving new devices. The only randomized controlled trial (RCT) was a pharmacologic clinical trial comparing duloxetine to placebo. The social continence rates were analyzed for 6 studies and were up to 66%.

Conclusion: New minimally invasive surgical procedures have emerged as the main alternative to AUS, with social continence rates up to 60% despite just 1 RCT studying the pharmacologic approach. There is an urgent need for well-designed clinical trials to clarify the role of new surgical alternatives in the management of SUI post-RP. New technologies should continue to be evaluated and compared with the AUS, which remains the gold standard.

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Published

2014-06-16

How to Cite

Caremel, R., & Corcos, J. (2014). Incontinence after radical prostatectomy: Anything new in its management?. Canadian Urological Association Journal, 8(5-6), 202–12. https://doi.org/10.5489/cuaj.1349

Issue

Vol. 8 No. 5-6 (2014): CUAJ June

Section

Review

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