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Urethral Bulking and Salvage Techniques for Post-Prostatectomy Incontinence

  • Benjamin M. DropkinEmail author
  • Sophia D. Delpe
  • Melissa R. Kaufman
Post-Prostatectomy and Acquired Voiding Dysfunction (V Tse, Section Editor)
  • 11 Downloads
Part of the following topical collections:
  1. Topical Collection on Post-Prostatectomy and Acquired Voiding Dysfunction
  2. Topical Collection on Post-Prostatectomy and Acquired Voiding Dysfunction

Abstract

Purpose of Review

Despite limited evidence and efficacy, urethral bulking remains a common treatment for post-prostatectomy stress urinary incontinence (PP-SUI). Herein we provide an overview of the existing evidence for synthetic bulking agents and emerging evidence for stem cell-based sphincter rejuvenation in this setting. We also touch upon salvage techniques for management of PP-SUI after failed anti-incontinence interventions.

Recent Findings

Autologous stem cell (ASC) therapies are currently undergoing phase III trials for use in female SUI and are poised to enter the market within the next decade. Early data suggests that they may have a future role in PP-SUI management as well. The artificial urinary sphincter (AUS) has emerged as the standard of care for salvage PP-SUI treatment.

Summary

Treatment paradigms for PP-SUI continue to evolve. Synthetic bulking remains common while autologous bulking looms as a potential future therapy. The AUS remains the last line of defense.

Keywords

Post-prostatectomy stress urinary incontinence Artificial urinary sphincter Urethral bulking Male sling Autologous stem cell transplant Pelvic floor physical therapy Adipose-derived stem cells Muscle-derived stem cells Urethral sphincter regeneration Salvage anti-incontinence therapy 

Notes

Compliance with Ethical Standards

Conflict of Interest

Dr. Kaufman serves as Global Principal Investigator for Cook Myosite.

Human and Animal Rights and Informed Consent

This article does not contain any published studies with human or animal subjects performed by any of the authors. Dr. Kaufman is the Principle Investigator of the CELLEBRATE trial [86].

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Benjamin M. Dropkin
    • 1
    Email author
  • Sophia D. Delpe
    • 1
  • Melissa R. Kaufman
    • 1
  1. 1.Department of Urologic Surgery, A-1302 Medical Center NorthVanderbilt University Medical CenterNashvilleUSA

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