Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Oct 3;5(11):1001-1010.
doi: 10.1002/bco2.442. eCollection 2024 Nov.

Outcome of post-prostatectomy stress urinary incontinence surgery in men with preoperative idiopathic detrusor overactivity

Nikita R Bhatt  1 , Simona Ippoliti  2 , Arjun Nambiar  3 , Cristian Ilie  1 , Ruth Doherty  1 , Lee Smith  4
Affiliations
Review

Outcome of post-prostatectomy stress urinary incontinence surgery in men with preoperative idiopathic detrusor overactivity

Nikita R Bhatt et al. BJUI Compass. .

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] BJUI Compass. 2024 Dec 30;5(12):1324-1329. doi: 10.1002/bco2.482. eCollection 2024 Dec. BJUI Compass. 2024. PMID: 39744071 Free PMC article.

Abstract

Background: Urodynamic evidence of storage dysfunction such as detrusor overactivity (DO) and/or poor compliance are present in up to 30-40% of patients after Radical Prostatectomy (RP). However, the current optimal management of men with DO on preoperative urodynamics prior to male stress urinary incontinence (SUI) surgery is not known.

Methods: We performed a systematic search of the literature including articles on patients undergoing SUI surgery after prostatectomy with preoperative DO between January 2003 and May 2023 to ensure contemporaneous data was obtained.

Results: We identified 11 eligible publications with a total of 792 patients. On Urodynamics, 29% (n = 229) patients had DO prior to SUI surgery. Overall 69% patients had a successful outcome after SUI surgery while 26% (132/499) failed while 34% (32/95) patients who had proven DO preoperatively failed SUI surgery. The difference was not statistically significant. Considering the sub-group analysis, the failure rate with preoperative DO was significantly higher in the sling group (43%) than in the AUS group (18%). The review was limited by the outcome heterogeneity, variability in study inclusion criteria, reporting and analysis and the quality of the available studies.

Conclusions: Within the limitations of the data, this review did not show a statistically significant higher failure rate of male incontinence surgery in patients with DO. Hence, patients with DO on preoperative urodynamics who are eligible for male SUI surgery should not be denied surgery but should be counselled appropriately of the risks and potential need for subsequent treatment, to manage expectations.

Keywords: male incontinence; overactive bladder; radical prostatectomy; storage dysfunction; stress urinary incontinence.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
PRISMA flowchart of studies.Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. Doi: 10.1136/bmj.n71. For more information, visit: http://www.prisma‐statement.org/
FIGURE 2
FIGURE 2
Risk of bias analysis.
See this image and copyright information in PMC

References

    1. Rahnama'i MS, Marcelissen T, Geavlete B, Tutolo M, Hüsch T. Current Management of Post‐radical Prostatectomy Urinary Incontinence. Front Surg. 2021;8:647656. 10.3389/fsurg.2021.647656 PMID: 33898508; PMCID: PMC8063855. - DOI - PMC - PubMed
    1. Kretschmer A, Nitti V. Surgical treatment of male Postprostatectomy incontinence: current concepts. Eur Urol Focus. 2017;3(4–5):364–376. 10.1016/j.euf.2017.11.007 PMID: Epub 2017 Nov 23. PMID: 29174616. - DOI - PubMed
    1. Soysal P, Veronese N, Ippoliti S, Pizzol D, Carrie AM, Stefanescu S, et al. European Society of Geriatric Medicine Special Interest Group in systematic reviews, meta‐analyses. The impact of urinary incontinence on multiple health outcomes: an umbrella review of meta‐analysis of observational studies. Aging Clin Exp Res. 2023;35(3):479–495. 10.1007/s40520-022-02336-0 PMID: Epub 2023 Jan 13. PMID: 36637774. - DOI - PubMed
    1. Biers S, Sievert K‐D, Thiruchelvam N. Overactive bladder syndrome and lower urinary tract symptoms after prostate cancer treatment. Curr Opinion Urol. 2017;27(3):307–313. 10.1097/MOU.0000000000000391 - DOI - PubMed
    1. Porena M, Mearini E, Mearini L, Vianello A, Giannantoni A. Voiding dysfunction after radical retropubic prostatectomy: more than external urethral sphincter deficiency. Eur Urol. 2007;52(1):38–45. 10.1016/j.eururo.2007.03.051 - DOI - PubMed

LinkOut - more resources