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Review
. 2023 Feb 2;12(3):1190.
doi: 10.3390/jcm12031190.

Latest Evidence on Post-Prostatectomy Urinary Incontinence

Mauro Gacci  1   2 , Cosimo De Nunzio  3 , Vasileios Sakalis  4 , Malte Rieken  5   6 , Jean-Nicolas Cornu  7 , Stavros Gravas  8
Affiliations
Review

Latest Evidence on Post-Prostatectomy Urinary Incontinence

Mauro Gacci et al. J Clin Med. .

Abstract

A radical prostatectomy is frequently used as the first-line treatment for men with prostate cancer. Persistent urinary incontinence after surgery is one of the most severe adverse events. We report the results of a comprehensive literature search focused on post-prostatectomy urinary incontinence (PPI), performed by a panel of experts on non-neurogenic lower urinary tract symptoms. The data on the prevalence and timing of PPI are very heterogeneous. The etiology of PPI can be multifactorial and mainly dependent on patient characteristics, lower urinary tract function or surgical issues. The medical history with a physical examination, the use of validated questionnaires with a voiding diary and pad tests are determinants in identifying the contributing factors and choosing the right treatment. Lifestyle intervention and urinary containment are the most frequently used strategies for the conservative management of PPI, while antimuscarinics, beta-3 agonists and duloxetine (off-label) are drugs indicated to manage PPI with a concomitant overactive bladder. Surgical therapies for the management of post-prostatectomy SUI include non-adjustable trans-obturator slings in men with mild-to-moderate incontinence and an artificial urinary sphincter in men with moderate-to-severe incontinence.

Keywords: PPI; antimuscarinics; artificial urinary sphincter; beta-3 agonists; duloxetine trans-obturator slings; pad test; post prostatectomy incontinence; prostate cancer; radical prostatectomy; robotic prostatectomy; urinary incontinence; voiding diary.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Diagnostic flowchart for patients with PPI3.3.
See this image and copyright information in PMC

References

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