Skip to main content

Advertisement

SpringerLink
Log in

Post-Prostatectomy Incontinence: an Update on Current Management

  • Cancer-Associated Voiding Dysfunction (S Elliott and J Pariser, Section Editors)
  • Published:
Current Bladder Dysfunction Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To review the most recent literature on the treatment of post-prostatectomy incontinence.

Recent Findings

New technology and implementation of surgical devices have resulted in a myriad of treatment options for men suffering post-prostatectomy incontinence. However, many of these have widely varied results.

Summary

The treatment of post-prostatectomy incontinence is consistent and continues to expand with more devices being introduced in the market. However, optimization of patient outcomes and determination of which devices work best will be required. To date, there are few randomized controlled trials for the treatment of post-prostatectomy incontinence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Ficarra V, Novara G, Rosen RC, Artibani W, Carroll PR, Costello A, et al. Systematic review and meta-analysis of studies reporting urinary continence recovery after robot-assisted radical prostatectomy. Eur Urol. 2012;62(3):405–17.

    PubMed  Google Scholar 

  2. Ficarra V, Novara G, Artibani W, Cestari A, Galfano A, Graefen M, et al. Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a systematic review and cumulative analysis of comparative studies. Eur Urol. 2009;55(5):1037–63.

    PubMed  Google Scholar 

  3. Wei Y, Wu Y-P, Lin M-Y, Chen S-H, Lin Y-Z, Li X-D, et al. Impact of obesity on long-term urinary incontinence after radical prostatectomy: a meta-analysis. Biomed Res Int. 2018;2018:1–9.

    Google Scholar 

  4. Wolin KY, Luly J, Sutcliffe S, Andriole GL, Kibel AS. Risk of urinary incontinence following prostatectomy: the role of physical activity and obesity. J Urol. 2010;183(2):629–33.

    PubMed  Google Scholar 

  5. Lavigueur-Blouin H, Noriega AC, Valdivieso R, Hueber P-A, Bienz M, Alhathal N, et al. Predictors of early continence following robot-assisted radical prostatectomy. Can Urol Assoc J. 2015;9(1–2):93.

    Google Scholar 

  6. Yamada Y, Fujimura T, Fukuhara H, Sugihara T, Miyazaki H, Nakagawa T, et al. Overactive bladder is a negative predictor of achieving continence after robot-assisted radical prostatectomy. Int J Urol. 2017;24(10):749–56.

    PubMed  Google Scholar 

  7. Pompe RS, Krüger A, Preisser F, Karakiewicz PI, Michl U, Graefen M, et al. The impact of anxiety and depression on surgical and functional outcomes in patients who underwent radical prostatectomy. Eur Urol Focus. 2018. https://doi.org/10.1016/j.euf.2018.12.008.

  8. Ikarashi D, Kato Y, Kanehira M, Takata R, Ito A, Onoda M, et al. Appropriate preoperative membranous urethral length predicts recovery of urinary continence after robot-assisted laparoscopic prostatectomy. World J Surg Oncol. 2018;16(224):224.

    PubMed  PubMed Central  Google Scholar 

  9. Kim LHC, Patel A, Kinsella N, Sharabiani MTA, Ap Dafydd D, Cahill D. Association between preoperative magnetic resonance imaging–based urethral parameters and continence recovery following robot-assisted radical prostatectomy. Eur Urol Focus. 2019. https://doi.org/10.1016/j.euf.2019.01.011.

  10. Satake Y, Kaiho Y, Saito H, Yamada T, Kawamorita N, Yamashita S, et al. Estimated minimal residual membranous urethral length on preoperative magnetic resonance imaging can be a new predictor for continence after radical prostatectomy. Urology. 2018;112:138–44.

    PubMed  Google Scholar 

  11. Lim SK, Kim KH, Shin T-Y, Han WK, Chung BH, Hong SJ, et al. Retzius-sparing robot-assisted laparoscopic radical prostatectomy: combining the best of retropubic and perineal approaches. BJU Int. 2014;114(2):236–44.

    PubMed  Google Scholar 

  12. • Menon M, Dalela D, Jamil M, Diaz M, Tallman C, Abdollah F, et al. Functional recovery, oncologic outcomes and postoperative complications after robot-assisted radical prostatectomy: an evidence-based analysis comparing the Retzius sparing and standard approaches. J Urol. 2018;199(5):1210–7. This paper showed improved early continence rates with retzius-sparing techniques but similar 1-year continence rates when compared to traditional approaches.

    PubMed  Google Scholar 

  13. Ma X, Tang K, Yang C, Wu G, Xu N, Wang M, et al. Bladder neck preservation improves time to continence after radical prostatectomy: a systematic review and meta-analysis. Oncotarget. 2016;7(41):67463–75.

    PubMed  PubMed Central  Google Scholar 

  14. Bellangino M, Verrill C, Leslie T, Bell RW, Hamdy FC, Lamb AD. Systematic review of studies reporting positive surgical margins after bladder neck sparing radical prostatectomy. Curr Urol Rep. 2017;18(12):99.

  15. Thüroff JW, Abrams P, Andersson K-E, Artibani W, Chapple CR, Drake MJ, et al. EAU guidelines on urinary incontinence. Eur Urol. 2011;59(3):387–400.

    PubMed  Google Scholar 

  16. Wallace SA, Roe B, Williams K, Palmer M. Bladder training for urinary incontinence in adults. Cochrane Database Syst Rev. 2004;1:CD001308.

    Google Scholar 

  17. Eustice S, Roe B, Paterson J. Prompted voiding for the management of urinary incontinence in adults. Cochrane Database Syst Rev. 2000;2:CD002113.

    Google Scholar 

  18. Mathewson-Chapman M. Pelvic muscle exercise/biofeedback for urinary incontinence after prostatectomy: an education program. J Cancer Educ Off J Am Assoc Cancer Educ. 1997;12(4):218–23.

    CAS  Google Scholar 

  19. Burgio KL, Goode PS, Urban DA, Umlauf MG, Locher JL, Bueschen A, et al. Preoperative biofeedback assisted behavioral training to decrease post-prostatectomy incontinence: a randomized, controlled trial. J Urol. 2006;175(1):196–201 discussion 201.

    PubMed  Google Scholar 

  20. Centemero A, Rigatti L, Giraudo D, Lazzeri M, Lughezzani G, Zugna D, et al. Preoperative pelvic floor muscle exercise for early continence after radical prostatectomy: a randomised controlled study. Eur Urol. 2010;57(6):1039–43.

    PubMed  Google Scholar 

  21. Tienforti D, Sacco E, Marangi F, D’Addessi A, Racioppi M, Gulino G, et al. Efficacy of an assisted low-intensity programme of perioperative pelvic floor muscle training in improving the recovery of continence after radical prostatectomy: a randomized controlled trial. BJU Int. 2012;110(7):1004–10.

    PubMed  Google Scholar 

  22. Bales GT, Gerber GS, Minor TX, Mhoon DA, McFarland JM, Kim HL, et al. Effect of preoperative biofeedback/pelvic floor training on continence in men undergoing radical prostatectomy. Urology. 2000;56(4):627–30.

    CAS  PubMed  Google Scholar 

  23. Dijkstra-Eshuis J, Van den Bos TWL, Splinter R, Bevers RFM, Zonneveld WCG, Putter H, et al. Effect of preoperative pelvic floor muscle therapy with biofeedback versus standard care on stress urinary incontinence and quality of life in men undergoing laparoscopic radical prostatectomy: a randomised control trial. Neurourol Urodyn. 2015;34(2):144–50.

    PubMed  Google Scholar 

  24. Geraerts I, Van Poppel H, Devoogdt N, Joniau S, Van Cleynenbreugel B, De Groef A, et al. Influence of preoperative and postoperative pelvic floor muscle training (PFMT) compared with postoperative PFMT on urinary incontinence after radical prostatectomy: a randomized controlled trial. Eur Urol. 2013;64(5):766–72.

    PubMed  Google Scholar 

  25. Wu M-L-Y, Wang C-S, Xiao Q, Peng C-H, Zeng T-Y. The therapeutic effect of pelvic floor muscle exercise on urinary incontinence after radical prostatectomy: a meta-analysis. Asian J Androl. 2019;21(2):170–176.

    PubMed  Google Scholar 

  26. • Chang JI, Lam V, Patel MI. Preoperative pelvic floor muscle exercise and postprostatectomy incontinence: a systematic review and meta-analysis. Eur Urol. 2016;69(3):460–7. This meta-analysis found improved early but not long-term continence with preoperative PFME.

    PubMed  Google Scholar 

  27. Goode PS, Burgio KL, Johnson TM, Clay OJ, Roth DL, Markland AD, et al. Behavioral therapy with or without biofeedback and pelvic floor electrical stimulation for persistent postprostatectomy incontinence: a randomized controlled trial. JAMA. 2011;305(2):151–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  28. Neumann PB, O’Callaghan M. The role of preoperative puborectal muscle function assessed by transperineal ultrasound in urinary continence outcomes at 3, 6, and 12 months after robotic-assisted radical prostatectomy. Int Neurourol J. 2018;22(2):114–22.

    PubMed  PubMed Central  Google Scholar 

  29. Yoshida M, Matsunaga A, Igawa Y, Fujimura T, Shinoda Y, Aizawa N, et al. May perioperative ultrasound-guided pelvic floor muscle training promote early recovery of urinary continence after robot-assisted radical prostatectomy? Neurourol Urodyn. 2019;38(1):158–64.

    PubMed  Google Scholar 

  30. Ribeiro LHS, Prota C, Gomes CM, de Bessa J, Boldarine MP, Dall’Oglio MF, et al. Long-term effect of early postoperative pelvic floor biofeedback on continence in men undergoing radical prostatectomy: a prospective, randomized, controlled trial. J Urol. 2010;184(3):1034–9.

    PubMed  Google Scholar 

  31. Lilli P, Mercuriali M, Fiori M, Hanitzsch H, Gunelli R, Bercovich E. Impact of preoperative biofeedback on incontinence in cancer patients undergoing radical prostatectomy. Arch Ital Urol Androl Organo Uff Soc Ital Ecogr Urol E Nefrol. 2006;78(3):92–6.

    Google Scholar 

  32. Wille S, Sobottka A, Heidenreich A, Hofmann R. Pelvic floor exercises, electrical stimulation and biofeedback after radical prostatectomy: results of a prospective randomized trial. J Urol. 2003;170(2 Pt 1):490–3.

    CAS  PubMed  Google Scholar 

  33. Filocamo MT, Li Marzi V, Del Popolo G, Cecconi F, Marzocco M, Tosto A, et al. Effectiveness of early pelvic floor rehabilitation treatment for post-prostatectomy incontinence. Eur Urol. 2005;48(5):734–8.

    PubMed  Google Scholar 

  34. Glazener C, Boachie C, Buckley B, Cochran C, Dorey G, Grant A, et al. Urinary incontinence in men after formal one-to-one pelvic-floor muscle training following radical prostatectomy or transurethral resection of the prostate (MAPS): two parallel randomised controlled trials. Lancet Lond Engl. 2011;378(9788):328–37.

    Google Scholar 

  35. Moore KN, Griffiths D, Hughton A. Urinary incontinence after radical prostatectomy: a randomized controlled trial comparing pelvic muscle exercises with or without electrical stimulation. BJU Int. 1999;83(1):57–65.

    CAS  PubMed  Google Scholar 

  36. Moore KN, Valiquette L, Chetner MP, Byrniak S, Herbison GP. Return to continence after radical retropubic prostatectomy: a randomized trial of verbal and written instructions versus therapist-directed pelvic floor muscle therapy. Urology. 2008;72(6):1280–6.

    PubMed  Google Scholar 

  37. Fernández RA, García-Hermoso A, Solera-Martínez M, Correa MTM, Morales AF, Martínez-Vizcaíno V. Improvement of continence rate with pelvic floor muscle training post-prostatectomy: a meta-analysis of randomized controlled trials. Urol Int. 2015;94(2):125–32.

    PubMed  Google Scholar 

  38. Yamanishi T, Mizuno T, Watanabe M, Honda M, Yoshida K-I. Randomized, placebo controlled study of electrical stimulation with pelvic floor muscle training for severe urinary incontinence after radical prostatectomy. J Urol. 2010;184(5):2007–12.

    PubMed  Google Scholar 

  39. • Laurienzo CE, Magnabosco WJ, Jabur F, Faria EF, Gameiro MO, Sarri AJ, et al. Pelvic floor muscle training and electrical stimulation as rehabilitation after radical prostatectomy: a randomized controlled trial. J Phys Ther Sci. 2018;30(6):825–31. This trial found no benefit for PFME or ES on recovery of urinary continence.

    PubMed  PubMed Central  Google Scholar 

  40. Berghmans B, Hendriks E, Bernards A, de Bie R, Omar MI. Electrical stimulation with non-implanted electrodes for urinary incontinence in men. Cochrane Database Syst Rev. 2013;6:CD001202.

    Google Scholar 

  41. Yokoyama T, Nishiguchi J, Watanabe T, Nose H, Nozaki K, Fujita O, et al. Comparative study of effects of extracorporeal magnetic innervation versus electrical stimulation for urinary incontinence after radical prostatectomy. Urology. 2004;63(2):264–7.

    PubMed  Google Scholar 

  42. Tantawy SA, Elgohary HMI, Abdelbasset WK, Kamel DM. Effect of 4 weeks of whole-body vibration training in treating stress urinary incontinence after prostate cancer surgery: a randomised controlled trial. Physiotherapy. 2018. https://doi.org/10.1016/j.physio.2018.07.013.

    PubMed  Google Scholar 

  43. Lee SW, Kang JH, Sung HH, Jeong U-S, Lee Y-S, Baek M, et al. Treatment outcomes of transurethral macroplastique injection for postprostatectomy incontinence. Korean J Urol. 2014;55(3):182–9.

    PubMed  PubMed Central  Google Scholar 

  44. Kim PH, Pinheiro LC, Atoria CL, Eastham JA, Sandhu JS, Elkin EB. Trends in the use of incontinence procedures after radical prostatectomy: a population based analysis. J Urol. 2013;189(2):602–8.

    PubMed  Google Scholar 

  45. Kahokehr AA, Selph JP, Belsante MJ, Bashir M, Sofue K, Tausch TJ, et al. Mechanism of action of the transobturator sling for post-radical prostatectomy incontinence: a multi-institutional prospective study using dynamic magnetic resonance imaging. Urology. 2018;116:185–92.

    PubMed  Google Scholar 

  46. Rehder P, Haab F, Cornu J-N, Gozzi C, Bauer RM. Treatment of postprostatectomy male urinary incontinence with the transobturator retroluminal repositioning sling suspension: 3-year follow-up. Eur Urol. 2012;62(1):140–5.

    PubMed  Google Scholar 

  47. Meisterhofer K, Herzog S, Strini KA, Sebastianelli L, Bauer R, Dalpiaz O. Male slings for postprostatectomy incontinence: a systematic review and meta-analysis. Eur Urol Focus. 2019 [cited 2019 Mar 13]. https://doi.org/10.1016/j.euf.2019.01.008.

  48. Kumar A, Litt ER, Ballert KN, Nitti VW. Artificial urinary sphincter versus male sling for post-prostatectomy incontinence—what do patients choose? J Urol. 2009;181(3):1231–5.

    PubMed  Google Scholar 

  49. Ye H, Haab F, de Ridder D, Chauveau P, Becker A, Arano P, et al. Effectiveness and complications of the AMS AdVanceTM male sling system for the treatment of stress urinary incontinence: a prospective multicenter study. Urology. 2018;120:197–204.

    PubMed  Google Scholar 

  50. Bauer RM, Grabbert MT, Klehr B, Gebhartl P, Gozzi C, Homberg R, et al. 36-month data for the AdVance XP® male sling: results of a prospective multicentre study. BJU Int. 2017;119(4):626–30.

    PubMed  Google Scholar 

  51. Comiter CV, Rhee EY, Tu LM, Herschorn S, Nitti VW. The virtue sling--a new quadratic sling for postprostatectomy incontinence--results of a multinational clinical trial. Urology. 2014;84(2):433–8.

    PubMed  Google Scholar 

  52. Ferro M, Bottero D, D’Elia C, Matei DV, Cioffi A, Cozzi G, et al. Virtue male sling for post-prostatectomy stress incontinence: a prospective evaluation and mid-term outcomes. BJU Int. 2017;119(3):482–8.

    PubMed  Google Scholar 

  53. McCall AN, Rivera ME, Elliott DS. Long-term follow-up of the virtue quadratic male sling. Urology. 2016;93:213–6.

    PubMed  Google Scholar 

  54. Hübner WA, Gallistl H, Rutkowski M, Huber ER. Adjustable bulbourethral male sling: experience after 101 cases of moderate-to-severe male stress urinary incontinence. BJU Int. 2011;107(5):777–82.

    PubMed  Google Scholar 

  55. Romano SV, Huebner W, Rocha FT, Vaz FP, Muller V, Nakamura F. A transobturator adjustable system for male incontinence: 30-month follow-up of a multicenter study. Int Braz J Urol. 2014;40(6):781–9.

    PubMed  Google Scholar 

  56. Hoda MR, Primus G, Fischereder K, Heyden B, Mohammed N, Schmid N, et al. Early results of a European multicentre experience with a new self-anchoring adjustable transobturator system for treatment of stress urinary incontinence in men. BJU Int. 2013;111(2):296–303.

    PubMed  Google Scholar 

  57. Esquinas C, Angulo JC. Effectiveness of adjustable transobturator male system (ATOMS) to treat male stress incontinence: a systematic review and meta-analysis. Adv Ther. 2019;36(2):426–41.

    CAS  PubMed  Google Scholar 

  58. Lee R, Te AE, Kaplan SA, Sandhu JS. Temporal trends in adoption of and indications for the artificial urinary sphincter. J Urol. 2009;181(6):2622–7.

    PubMed  Google Scholar 

  59. Chung E, Ranaweera M, Cartmill R. Newer and novel artificial urinary sphincters (AUS): the development of alternatives to the current AUS device. BJU Int. 2012;110(S4):5–11.

    PubMed  Google Scholar 

  60. Gousse AE, Madjar S, Lambert MM, Fishman IJ. Artificial urinary sphincter for post-radical prostatectomy urinary incontinence: long-term subjective results. J Urol. 2001;166(5):1755–8.

    CAS  PubMed  Google Scholar 

  61. •• Suh YS, Ko KJ, Kim TH, Sung HH, Lee K-S. Long-term outcomes of primary implantation and revisions of artificial urinary sphincter in men with stress urinary incontinence. Neurourol Urodyn. 2017;36(7):1930–7. This trial found decreased efficacy of AMS 800 AUS with secondary vs. primary implantation.

    PubMed  Google Scholar 

  62. Haab F, Trockman BA, Zimmern PE, Leach GE. Quality of life and continence assessment of the artificial urinary sphincter in men with minimum 3.5 years of followup. J Urol. 1997;158(2):435–9.

    CAS  PubMed  Google Scholar 

  63. Montague DK, Angermeier KW, Paolone DR. Long-term continence and patient satisfaction after artificial sphincter implantation for urinary incontinence after prostatectomy. J Urol. 2001;166(2):547–9.

    CAS  PubMed  Google Scholar 

  64. Kim SP, Sarmast Z, Daignault S, Faerber GJ, McGuire EJ, Latini JM. Long-term durability and functional outcomes among patients with artificial urinary sphincters: a 10-year retrospective review from the University of Michigan. J Urol. 2008;179(5):1912–6.

    PubMed  Google Scholar 

  65. • Yafi FA, DeLay KJ, Stewart C, Chiang J, Sangkum P, Hellstrom WJG. Device survival after primary implantation of an artificial urinary sphincter for male stress urinary incontinence. J Urol. 2017;197(3 Pt 1):759–65. There may be an association between younger age and penoscrotal approach with increased explantation and revision rates for the AMS 800.

    PubMed  Google Scholar 

  66. Elliott DS, Barrett DM. Mayo Clinic long-term analysis of the functional durability of the AMS 800 artificial urinary sphincter: a review of 323 cases. J Urol. 1998;159(4):1206–8.

    CAS  PubMed  Google Scholar 

  67. Raj GV, Peterson AC, Toh KL, Webster GD. Outcomes following revisions and secondary implantation of the artificial urinary sphincter. J Urol. 2005;173(4):1242–5.

    PubMed  Google Scholar 

  68. O’Connor RC, Lyon MB, Guralnick ML, Bales GT. Long-term follow-up of single versus double cuff artificial urinary sphincter insertion for the treatment of severe postprostatectomy stress urinary incontinence. Urology. 2008;71(1):90–3.

    PubMed  Google Scholar 

  69. DiMarco DS, Elliott DS. Tandem cuff artificial urinary sphincter as a salvage procedure following failed primary sphincter placement for the treatment of post-prostatectomy incontinence. J Urol. 2003;170(4 Pt 1):1252–4.

    PubMed  Google Scholar 

  70. Guralnick ML, Miller E, Toh KL, Webster GD. Transcorporal artificial urinary sphincter cuff placement in cases requiring revision for erosion and urethral atrophy. J Urol. 2002;167(5):2075–8 discussion 2079.

    PubMed  Google Scholar 

  71. Gomha MA, Boone TB. Artificial urinary sphincter for post-prostatectomy incontinence in men who had prior radiotherapy: a risk and outcome analysis. J Urol. 2002;167(2 Pt 1):591–6.

    PubMed  Google Scholar 

  72. • Kaufman MR, Milam DF, Johnsen NV, Cleves MA, Broghammer JA, Brant WO, et al. Prior radiation therapy decreases time to idiopathic erosion of artificial urinary sphincter: a multi-institutional analysis. J Urol. 2018;199(4):1037–41. This study found increased erosion rate of the AMS 800 in irradiated patients.

    PubMed  Google Scholar 

  73. Fisher MB, Aggarwal N, Vuruskan H, Singla AK. Efficacy of artificial urinary sphincter implantation after failed bone-anchored male sling for postprostatectomy incontinence. Urology. 2007;70(5):942–4.

    PubMed  Google Scholar 

  74. •• Constable L, Cotterill N, Cooper D, Glazener C, Drake MJ, Forrest M, et al. Male synthetic sling versus artificial urinary sphincter trial for men with urodynamic stress incontinence after prostate surgery (MASTER): study protocol for a randomised controlled trial. Trials. 2018;19(1):131. This trial will directly compare male sling vs. AUS.

    PubMed  PubMed Central  Google Scholar 

  75. García Montes F, Knight SL, Greenwell T, Mundy AR, Craggs MD. “Flowsecure” artificial urinary sphincter: a new adjustable artificial urinary sphincter concept with conditional occlusion for stress urinary incontinence. Actas Urol Esp. 2007;31(7):752–8.

    PubMed  Google Scholar 

  76. Knight SL, Susser J, Greenwell T, Mundy AR, Craggs MD. A new artificial urinary sphincter with conditional occlusion for stress urinary incontinence: preliminary clinical results. Eur Urol. 2006;50(3):574–80.

    PubMed  Google Scholar 

  77. Llorens C, Pottek T. Urinary artificial sphincter ZSI 375 for treatment of stress urinary incontinence in men: 5 and 7 years follow-up report. Urologia. 2017;84(4):263–6.

    PubMed  Google Scholar 

  78. • Kretschmer A, Hüsch T, Thomsen F, Kronlachner D, Pottek T, Obaje A, et al. Efficacy and safety of the ZSI375 artificial urinary sphincter for male stress urinary incontinence: lessons learned. World J Urol. 2016;34(10):1457–63. This study demonstrated an explantation rate of 62% for the Zephyr sphincter.

    PubMed  Google Scholar 

  79. Ostrowski I, Ciechan J, Sledz E, Dys W, Golabek T, Chłosta PL. Four-year follow-up on a Zephyr Surgical Implants 375 artificial urinary sphincter for male urinary incontinence from one urological centre in Poland. Cent Eur J Urol. 2018;71(3):320–5.

    Google Scholar 

  80. de O Vilar F, Araújo LAP, Lima SVC. Periurethral constrictor in pediatric urology: long-term followup. J Urol. 2004;171(6 Pt 2):2626–8.

    Google Scholar 

  81. Introini C, Naselli A, Zaninetta G, Timossi L, Guaglianone S, Simone G, et al. Safety and efficacy of periurethral constrictor implantation for the treatment of post-radical prostatectomy incontinence. Urology. 2012 May;79(5):1175–8.

    PubMed  Google Scholar 

  82. Lima RS, Barros EGC, Souza CA, de O Vilar F, Lima SVC. Periurethral constrictor: late results of the treatment of post prostatectomy urinary incontinence. Int Braz J Urol Off J Braz Soc Urol. 2011;37(4):483–7.

    Google Scholar 

  83. • Favro M, Billia M, Volpe A, Zacchero M, Terrone C. Long-term outcomes of the implant of a periurethral constrictor for stress urinary incontinence following radical prostatectomy. Urol Int. 2016;97(1):26–31. This study demonstrated a complication rate of 78% with the Periurethral Constrictor.

    PubMed  Google Scholar 

  84. Reuvers SHM, Groen J, Scheepe JR, Blok BFM. Maximum urethral closure pressure increases after successful adjustable continence therapy (ProACT) for stress urinary incontinence after radical prostatectomy. Urology. 2016;94:188–92.

    PubMed  Google Scholar 

  85. • Nash S, Aboseif S, Gilling P, Gretzer M, Samowitz H, Rose M, et al. Four-year follow-up on 68 patients with a new post-operatively adjustable long-term implant for post-prostatectomy stress incontinence: ProACTTM. Neurourol Urodyn. 2019;38(1):248–53. This trial demonstrated a significant improvement in urine loss with the ProACT system.

    PubMed  Google Scholar 

  86. Nestler S, Thomas C, Neisius A, Rubenwolf P, Roos F, Hampel C, et al. Long-term results of ProACT primary and repeat implantation for treatment of stress urinary incontinence in men. World J Urol. 2019;37(6):1173–1179.

    PubMed  Google Scholar 

  87. Rouprêt M, Misraï V, Gosseine P-N, Bart S, Cour F, Chartier-Kastler E. Management of stress urinary incontinence following prostate surgery with minimally invasive adjustable continence balloon implants: functional results from a single center prospective study. J Urol. 2011;186(1):198–203.

    PubMed  Google Scholar 

  88. Gregori A, Romanò AL, Scieri F, Pietrantuono F, Incarbone GP, Salvaggio A, et al. Transrectal ultrasound-guided implantation of adjustable continence therapy (ProACT): surgical technique and clinical results after a mean follow-up of 2 years. Eur Urol. 2010;57(3):430–6.

    PubMed  Google Scholar 

  89. Hübner WA, Schlarp OM. Adjustable continence therapy (ProACT): evolution of the surgical technique and comparison of the original 50 patients with the most recent 50 patients at a single centre. Eur Urol. 2007;52(3):680–6.

    PubMed  Google Scholar 

  90. Venturino L, Dalpiaz O, Pummer K, Primus G. Adjustable continence balloons in men: adjustments do not translate into long-term continence. Urology. 2015;85(6):1448–52.

    PubMed  Google Scholar 

  91. Lebret T, Cour F, Benchetrit J, Grise P, Bernstein J, Delaporte V, et al. Treatment of postprostatectomy stress urinary incontinence using a minimally invasive adjustable continence balloon device, ProACT: results of a preliminary, multicenter, pilot study. Urology. 2008;71(2):256–60.

    PubMed  Google Scholar 

  92. Matsukawa Y, Yoshino Y, Ishida S, Fujita T, Majima T, Funahashi Y, et al. De novo overactive bladder after robot-assisted laparoscopic radical prostatectomy. Neurourol Urodyn. 2018;37(6):2008–14.

    PubMed  Google Scholar 

  93. Hosier GW, Tennankore KK, Himmelman JG, Gajewski J, Cox AR. Overactive bladder and storage lower urinary tract symptoms following radical prostatectomy. Urology. 2016;94:193–7.

    PubMed  Google Scholar 

  94. Kim M, Park M, Shim M, Choi S-K, Lee SM, Lee E-S, et al. Effect of preoperative urodynamic detrusor overactivity on post-prostatectomy incontinence: a systematic review and meta-analysis. Int Urol Nephrol. 2016;48(1):53–63.

    CAS  PubMed  Google Scholar 

  95. Liu M, Pickles T, Berthelet E, Agranovich A, Kwan W, Tyldesley S, et al. Urinary incontinence in prostate cancer patients treated with external beam radiotherapy. Radiother Oncol J Eur Soc Ther Radiol Oncol. 2005;74(2):197–201.

    Google Scholar 

  96. • van Dessel LF, Reuvers SHM, Bangma CH, Aluwini S. Salvage radiotherapy after radical prostatectomy: long-term results of urinary incontinence, toxicity and treatment outcomes. Clin Transl Radiat Oncol. 2018;11:26–32. The de nono SUI rate for salvage RT after RP may be as high as 17%.

    PubMed  PubMed Central  Google Scholar 

  97. • Nyarangi-Dix JN, Steimer J, Bruckner T, Jakobi H, Koerber SA, Hadaschik B, et al. Post-prostatectomy radiotherapy adversely affects urinary continence irrespective of radiotherapy regime. World J Urol. 2017;35(12):1841–7. This study found no difference in SUI between adjuvant, early salvage, and salvage radiotherapy.

    CAS  PubMed  Google Scholar 

  98. Stephenson AJ, Scardino PT, Bianco FJ, DiBlasio CJ, Fearn PA, Eastham JA. Morbidity and functional outcomes of salvage radical prostatectomy for locally recurrent prostate cancer after radiation therapy. J Urol. 2004;172(6 Pt 1):2239–43.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mail Stop 3016, Kansas, KS, 66205, USA

    Charles P. Jones, Jack G. Campbell & Joshua A Broghammer

Authors
  1. Charles P. Jones
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jack G. Campbell
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Joshua A Broghammer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joshua A Broghammer.

Ethics declarations

Conflict of Interest

Joshua A. Broghammer is a paid consultant and proctor for Boston Scientific, Marlborough, MA. Charles P. Jones and Jack G. Campbell declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Cancer-Associated Voiding Dysfunction

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jones, C.P., Campbell, J.G. & Broghammer, J.A. Post-Prostatectomy Incontinence: an Update on Current Management. Curr Bladder Dysfunct Rep 14, 256–265 (2019). https://doi.org/10.1007/s11884-019-00559-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11884-019-00559-y

Keywords

Search

Navigation