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. 2014;16(4):181-8.

Post-radical prostatectomy incontinence: etiology and prevention

Kimberley Hoyland  1 , Nikhil Vasdev  1 , Ahmed Abrof  1 , Gregory Boustead  1
Affiliations

Post-radical prostatectomy incontinence: etiology and prevention

Kimberley Hoyland et al. Rev Urol. 2014.

Abstract

All patients undergoing a radical prostatectomy (RP) using any surgical approach, be it open, laparoscopic, or robotic, are at risk of developing postprostatectomy urinary incontinence. This side effect of RP has an effect on the patient's quality of life and can be associated with moderate to severe postoperative morbidity. The authors present a review of the etiology and prevention strategies of postprostatectomy urinary incontinence. Based on the current literature, the authors conclude that there is a paucity of studies that can accurately answer the exact anatomic and physiologic etiologies of postprostatectomy urinary incontinence. The aim of urologic surgeons performing RP should be to reduce the rate of postoperative incontinence rather than attempting to treat it once it has occurred. Further studies aimed at providing a detailed anatomic map of the pelvic anatomy related to continence will help to improve surgical techniques and reduce postoperative urinary incontinence following RP.

Keywords: Radical prostatectomy; Urethral length; Urinary incontinence.

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Figures

Figure 1
Figure 1
The surgical anatomy of the male urethral sphincter complex prior to radical prostatectomy. B, bladder; DA, detrusor apron; FSS, fascia of the striated sphincter; ML, Mueller’s ligaments; MDR, medical dorsal raphe; NVB, neurovascular bundle; OS, Os ischiadicum; PB, pubis bone; P, prostate; PPL, pubovescicalis ligament; PP, puboperinealis muscle; R, rectum; RU, rectourethralis muscle; SS, striated sphincter.
Figure 2
Figure 2
The surgical anatomy of the male urethral complex following a radical prostatectomy. B, bladder; DA, detrusor apron; FSS, fascia of the striated sphincter; ML, Mueller's ligaments; MDR, medical dorsal raphe; NVB, neurovascular bundle; OS, Os ischiadicum; PB, pubis bone; P, prostate; PPL, pubovescicalis ligament; PP, puboperinealis muscle; R, rectum; RU, rectourethralis muscle; SS, striated sphincter.
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