Post-prostatectomy incontinence

Post-prostatectomy incontinence

Risk of Incontinence after Radical Prostatectomy According to Procedural Types: Retrospective Cohort Study Using National Health Insurance Data.

Although surgical procedures including robotic surgery in radical prostatectomy have evolved, urinary incontinence after surgery are still not resolved. This study was to evaluate the risk of clinically significant incontinence after radical prostatectomy according to various procedural types.

Short-Term Urinary Incontinence After Radical Prostatectomy Is Still Based on Patients' Age, Nerve-Sparing Approach, and Surgical-Experience, Despite the Higher-Use of Robotic Surgery in 2022 Compared to 2016 Real-World Results of a Large Rehabilitation C

Despite constant improvements, incontinence is one of the most relevant and quality-of-life-reducing side effects of radical prostatectomy (RP) and, in addition to patient-specific factors such as age, the experience of the surgeon/center and the surgical technique used play an important role.

Post-prostatectomy incontinence: a guideline of guidelines

Aim: To provide a comprehensive review of guidelines from various professional organisations on the work-up and management of post-prostatectomy Incontinence (PPI).

Materials and methods: The following guidelines were included in this review: European Association of Urology (EAU 2023), American Urological Association/Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (AUA/SUFU 2019), International Consultation on Incontinence (ICI, 2018), the Canadian Urological Association (CUA, 2012) and the Urological Society of India (USI, 2018).

Results: In general, the guidelines concur regarding the significance of conducting a comprehensive history and physical examination for patients with post-prostatectomy incontinence (PPI). However, there are variations among the guidelines concerning the recommended additional investigations. In cases of troublesome PPI, male slings are typically recommended for mild to moderate urinary incontinence (UI), while artificial urinary sphincters are preferred for moderate to severe UI, although the precise definition of this severity remains unclear. The guidelines provided by AUA/SUFU and the ICI have offered suggestions for managing complications or persistent/recurrent UI post-surgery, though some differences can be observed within these recommendations as well.

Conclusion: This is a first of its kind review encompassing Guidelines on PPI spanning over a decade. Although guidelines share overarching principles, nuanced variations persist, posing challenges for clinicians. This compilation consolidates and highlights both the similarities and differences among guidelines, providing a comprehensive overview of PPI diagnosis and management for practitioners. It is our expectation that as more evidence emerges in this and other areas of PPI management, the guidelines will converge and address crucial patient-centric aspects.

Nikita R Bhatt,¹ Aswathy Pavithran,² Cristian Ilie,¹ Lee Smith,³ Ruth Doherty,¹

Norfolk and Norwich University Hospitals, Norwich, UK.
Royal Derby Hospital, Derby, UK.
Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK.

Source: Bhatt N., Pavithran A., Ilie C et al. Post-prostatectomy incontinence: a guideline of guidelines. BJU Int. 2024 May;133(5):513-523. doi: 10.1111/bju.16233.

Predictive factors of immediate continence after conventional robot-assisted radical prostatectomy: a single-institution retrospective study.

To assess the predictive factors of immediate urinary continence after robot-assisted radical prostatectomy.

This study included 282 patients who underwent conventional robot-assisted radical prostatectomy at our institution from April 2019 to March 2024.

Integrating clinical and image-based parameters for prediction of early post-prostatectomy incontinence recovery: simplified nomogram approach.

This study aimed to develop a novel model that combines both clinical and image-based parameters to predict early recovery of urinary incontinence after robotic-assisted radical prostatectomy (RARP) more easily and precisely.

Study design and procedures in the incontinence post robot-assisted radical prostatectomy: anatomical and functional causes (IPA) - a prospective observational clinical trial.

To describe the study design and procedures of the incontinence post robot- assisted radical prostatectomy, anatomical and functional causes (IPA) trial. This trial aims to identify and study patient and procedure specific factors leading to urinary incontinence post robot-assisted laparoscopic radical prostatectomy (RALP).

The history of prosthetic devices for postprostatectomy incontinence

Urinary incontinence has been studied since the Egyptian era of the second millennium BCE. Throughout history, several devices have been developed to address this condition. The prevalence of stress incontinence has increased with the surgical treatment of prostatectomy. Since 1947, numerous devices have been developed for the treatment of this condition. We performed a narrative literature review conducted through PubMed and Google Scholar, aimed at creating a chronological outline of devices developed for managing post-prostatectomy urinary incontinence. The first known compression device introduced in 1910 evolved into advanced systems like the AMS 800 artificial urinary sphincter, key milestones in device technology and surgical techniques. Nowadays, several new devices have been developed, each incorporating an innovative solution. In addition, a new artificial sphincter also had been advanced. The incorporation of electronic sphincter control systems seems to be the next innovation. Through continuous innovation, the field has advanced from basic solutions to sophisticated, customized treatments, providing hope and enhancing the quality of life for affected individuals. The evolution of these devices not only marks a journey through history but also illustrates a future where technological advancements continue to play a pivotal role in stress incontinence after prostatectomy.

Juliusz J. Szczesniewski,^a David E. Díaz,^aMiguel Virseda-Chamorro,^b,dGiordano Polisini,^cEnrico Ammirati,^dAlessandro Giammò^d

Urology Department, Getafe University Hospital, Carretera Madrid-Toledo km 12,500 Getafe, 28905, Madrid, Spain
Urology Department, Hospital Nacional de Parapléjicos, 45071 Toledo, Spain
Division of Urology, University Hospital “Ospedali Riuniti”, School of Medicine, Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, Ancona, Italy
NeuroUrology, CTO-Spinal Cord Unit, City of Health and Science of Turin, Turin, Italy

Source: Szczesniewski JJ., Díaz DE., Virseda-Chamorro M. et al. The history of prosthetic devices for postprostatectomy incontinence. Continence Reports. Volume 12, 2024, 100063, ISSN 2772-9745, https://doi.org/10.1016/j.contre.2024.100063.

Clinical efficacy of a rehabilitation management protocol for urinary incontinence after robot-assisted laparoscopic prostatectomy.

To evaluate the application of a rehabilitation management protocol for urinary incontinence after robot-assisted laparoscopic prostatectomy (RALP).

We conducted a retrospective cohort study of 114 patients who underwent RALP between August 2021 and November 2021 as the control group and a prospective analysis of 114 patients who underwent RALP between May 2022 and August 2022 as the experimental group.

Nomogram predicting early urinary incontinence after radical prostatectomy.

One of the most frequent side effects of radical prostatectomy (RP) is urinary incontinence. The primary cause of urine incontinence is usually thought to be impaired urethral sphincter function; nevertheless, the pathophysiology and recovery process of urine incontinence remains unclear.

Penile compression devices for the treatment of urinary incontinence: current status and future prospects.

Urinary incontinence (UI), especially stress UI, is common after prostatectomy. Penile compression devices (PCDs) may be a safe, tolerable option for conservative management in men who are not candidates for or not interested in surgical intervention for their UI.

Recent Advances in Diagnosing and Treating Post-Prostatectomy Urinary Incontinence.

Radical prostatectomy and radiotherapy are common first-line treatments for clinically localized prostate cancer. Despite advances in surgical technology and multidisciplinary management, post-prostatectomy urinary incontinence (PPI) remains a common clinical complication.

Surgical management of post prostatectomy incontinence.

Post prostatectomy incontinence (PPI) is a well-recognized and bothersome complication following radical prostatectomy. Conservative measures such as pelvic floor physical therapy, biofeedback, and medication are first line management of PPI.

Conservative interventions for female exercise-induced urinary incontinence: a systematic review.

To systematically review and synthesise what is known about the effectiveness of non-pharmaceutical conservative interventions for the management of urinary incontinence (UI) experienced by women during physical exercise.

Predictive value of preoperative pelvic floor electrophysiological parameters on early urinary incontinence following radical prostatectomy.

To explore the predictive value of preoperative pelvic floor electromyography (EMG) parameters for the risk of urinary incontinence after prostate cancer surgery.

This study retrospectively analyzed the medical records of 271 patients who underwent radical prostatectomy in the urology department of Peking University First Hospital from January 2020 to October 2022.

Clinical characteristics and predictors of long-term postoperative urinary incontinence in patients treated with robot-assisted radical prostatectomy: A propensity-matched analysis.

This study aimed to elucidate the clinical characteristics and predictors of long-term postoperative urinary incontinence (PUI) after robot-assisted radical prostatectomy (RARP).

This study included patients who underwent RARP at our institution and were stratified into PUI (≥1 pad/day) and continence (0 pad/day) groups at 60 months after RARP.

Clinical Study on Low-Frequency Electrical Pulse Acupoint Stimulation Combined with Pelvic Floor Muscle Exercise in the Treatment of Urinary Incontinence after Radical Prostatectomy.

Urinary incontinence (UI) is a common complication after radical prostatectomy (RP). It has a great influence on the postoperative quality of life of patients. This study aims to explore the clinical efficacy of low-frequency electrical pulse acupoint stimulation combined with pelvic floor muscle exercise in the treatment of UI after RP.

Predictors of Early Continence Recovery Following Radical Prostatectomy, Including Transperineal Ultrasound to Evaluate the Membranous Urethra Length (CHECK-MUL Study).

To predict early continence recovery following radical prostatectomy (RP) using baseline demographic and clinical data, as well as dynamic transperineal ultrasound (TPUS) parameters of membranous urethral length (MUL).

Inguinal Hernia Leads to Worse Immediate Urinary Continence after Robot-Assisted Radical Prostatectomy - Beyond the Abstract

This single-institution retrospective study showed that patients with concurrent inguinal hernia or a history of adult inguinal hernia had worse immediate urinary continence, possibly due to voiding dysfunction and weaker urethra-stabilizing periurethral fascial tissues. In this cohort, patients with inguinal hernia were older and had a lower body mass index.

Preliminary results of the external urinary sphincter Uroflex® on the quality of life of patients with male urinary incontinence after prostate surgery: tolerance, severity of incontinence, and quality of life.

This study aims to establish the ability of the Uroflex® external artificial sphincter to reduce the severity of male urinary incontinence and improve the quality of life of patients with male urinary incontinence.

Effect of Pilates combined with pelvic floor muscle training on continence of post-prostatectomy incontinence in patients with different body mass index.

Urinary incontinence symptoms severely affect older people with different body mass index (BMI).To compare the efficacy of the pelvic floor muscle training (PFMT) in patients with post-prostatectomy incontinence with different BMI.

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