Evaluation of Benefits and Harms of Surgical Treatments for Post–radical Prostatectomy Urinary Incontinence: A Systematic Review and Meta-analysis

Choiniere, Roselyne; Violette, Philippe D.; Morin, Mélanie; Tu, Le Mai; Guyatt, Gordon; Reed, Christine; Philie, Camille-Ariane; Legault, Benjamin; Beaudry, Marie-Michèle; Ahmed, Muhammad Muneeb; Richard, Patrick O.

doi:10.1016/j.euf.2021.09.007

Cited by 13 publications

(6 citation statements)

References 39 publications

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“…In addition, they found that those patients treated with radiotherapy had a lower success rate and higher rate of urethral erosion. Several updated studies and systematic reviews have replicated these results ( 17 , 24 , 25 ). Based on the available data, the American Urological Association (AUA) guidelines state that men with mild incontinence after prostate treatment can be offered adjustable balloon device; however, artificial urinary sphincter (AUS) is preferred in patients who underwent radiotherapy ( 1 ).…”

Section: Managementmentioning

confidence: 72%

“…Compared with other surgical therapies for post-prostatectomy urinary incontinence, urethral bulking agents provide the lowest cure rate. According to a systematic review by Choinière et al , the cure rate was found to be around 26% ( 17 ). Despite the known low efficacy, bulking agents are still one of the most used incontinence therapies utilized by urologists ( 18 ).…”

Section: Managementmentioning

confidence: 99%

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Treatment of male stress urinary incontinence at time of inflatable penile prosthesis placement a review of contemporary literature

Elbakry,

O’Connor,

Yafi

et al. 2024

Transl Androl Urol

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Background and Objective Male stress urinary incontinence (SUI) and erectile dysfunction (ED) are well established diagnoses within Men’s Health, often more specifically within the prostate cancer survivorship cohort. Taken individually, well defined treatment algorithms exist with which many surgeons are comfortable; however, treatment of both in a single setting or staged fashion introduces complexity. Emerging treatment options also exist, and there is immature or minimal data when these are combined with inflatable penile prosthesis (IPP) insertion, radiation history, and/or variable degrees of incontinence. Our objective was to describe and summarize the currently available treatment options for SUI particularly at the time of IPP insertion. Methods A literature review was performed to summarize contemporary treatment of SUI at time of IPP placement. Anecdotal experience was added from high volume, subspecialty trained Men’s Health and Reconstructive Urologists. Key Content and Findings Non-invasive approaches such as pelvic floor muscle training (PFMT), behavioral modification, and external compression devices play some limited role in treatment and/or management of SUI, particularly in the early post operative period, or for those unwilling or unable to undergo more definitive intervention. More invasive options such as artificial urinary sphincter (AUS) implantation, male sling, or other implantable devices are more appropriate for good surgical candidates with higher bother and/or more severe incontinence. These options can be concomitant or staged relative to IPP placement. Climacturia, particularly with mild or no bothersome SUI, can successfully be addressed at the time of penile prosthesis placement with the utilization of the Mini-Jupette suburethral sling. Conclusions A variety of treatment options exist for concomitant treatment of SUI at time of IPP, and both safety and efficacy have been demonstrated for many in the same operative setting. As with treatment of ED or SUI in isolation, patient selection, careful counseling, and management of expectations can lead to high patient satisfaction.

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Section: Managementmentioning

confidence: 72%

Section: Managementmentioning

confidence: 99%

Treatment of male stress urinary incontinence at time of inflatable penile prosthesis placement a review of contemporary literature

Elbakry,

O’Connor,

Yafi

et al. 2024

Transl Androl Urol

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“…Sling surgery was correlated to a reoperation rate of 5.8% (95% CI: 1.9–11.6, I2 = 94.1%, moderate level of evidence), ProACT 23.8% (95% CI: 5.9–61.0, I2 = 95.5%, level of evidence), AUS 22.2% (95% CI: 15.2–31.3, I2 = 92.3%, high evidence). The efficacy of bulking agents was 26.1% (95% CI: 10.6–51.4, I2 = 92.8%, a very low level of evidence), slings 58.6% (95% CI: 51.3–65.5, I2 = 89.1%, a low level of evidence), ProACT63.2% (95% CI: 57.6–68.5, I2 = 22.5%, a very low level of evidence), and AUS 74.0% (95% CI: 61.2–83.7, I2 = 92.1%, a very low level of evidence) [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Long-Term Survival Rate of ATOMS Implant for Male Stress Urinary Incontinence and Management of Late Complications

Giammò

Ammirati

2023

JCM

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Background: stress urinary incontinence (SUI) still represents a major drawback of prostate surgery. The aim of this study is to evaluate long term efficacy, safety and survival of ATOMS system implant in a single center. Methods: we retrospectively included al consecutive patients treated with ATOMS implant for SUI from October 2014 to July 2019. Patients received anamnesis, urodynamic evaluation, pre- and postoperative 24 h pad test and count. Patients were considered “continent” when dry or when wearing a security pad (social continence). Results: we treated99 patientswith median age 77.98 years (IQR 72.7–82.52). Most of the patients had undergone radical prostatectomy. Median follow-up was 62.9 months (IQR 47.5–75.9). At last follow-up 74 (74.7%) patients reported continence.We had 21 early (<30 days) postoperative complications, all Clavien-Dindo (CD) grade 1: [11 temporary perineal pain, 4 urinary retention, 3 scrotal edema, 2 superficial wound dehiscence, 1 dysuria]. We had late postoperative complications in 28 patients 7 port dislocations requiring surgical repositioning (CD 3a), 6 device removals (CD 3a) due to port erosion (2), inefficacy (2), cushion leakage (1), mesh detachment (1), perineal pain (5), 2 cases of port extrusion solved with port removal leaving the device in place (CD 3a), 2 superficial wound dehiscence (CD 1), 2 UTI (CD 1), 1 scrotal edema (CD 1), 1 cushion deflate (CD 1), 1 dysuria (CD 1), 1 perineal pain (CD 1). The survival of the device was 97% at 12 months, 93% at 24 months, 91% at 36 months, 90% at 48 months and 87.9% at 60 months. Conclusions: This study demonstrates the good safety and efficacy of ATOMS implant for the treatment of SUI.

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“…Hence, protecting male sexual function and urinary control is an important issue in this field. How to maximize the preservation of patients’ urinary control and erectile function has become a major concern for patients with localized prostate cancer [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Transversal approach via a bladder neck and prostate combined longitudinal incision versus standard approach of robotic-assisted radical prostatectomy for localized prostate cancer: a retrospective analysis

Shen,

Yao,

Bai

et al. 2024

BMC Cancer

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Background Transversal approach for robotic-assisted radical prostatectomy via a bladder neck and prostate combined longitudinal incision (L-RALP) is a novel surgical method for patients with respectable prostate cancer. Methods There were 669 patients with prostate cancer underwent L-RALP or S-RALP which identified from April 2016 to April 2020. The perioperative outcomes, Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP) scores, sexual function and urinary control ability were included and compared between two groups. Results In the 669 patients, 277 of them were included into the final analysis. 151 patients received S-RALP and 126 received L-RALP. Baseline features were balanced. Patients in the S-RALP group had significantly shorter average surgical time (135.93 vs 150.04 min; p < 0.001) than those in L-RALP group. Intraoperative bleeding volume, early postoperative complications rates, postoperative catheter removal time and hospital stays were comparable between two groups. There was no difference in biochemical recurrence at 3, 6, 12 and 18 months of follow-up. Of note, the urinary control function recovers of patients in the L-RALP group was significantly better than those in the S-RALP group. Moreover, patients in the L-RALP group had much better results of EPIC-CP (including urinary control and total score) than those in the S-RALP group at 6 week and 3, 6, 12 and 18 months. Conclusions Both S-RALP and L-RALP were safe and effective with similar long-term clinical outcomes in patients with respectable prostate cancer. Patients received L-RALP had significantly better postoperative outcomes including urinary control, and recovery period.

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Evaluation of Benefits and Harms of Surgical Treatments for Post–radical Prostatectomy Urinary Incontinence: A Systematic Review and Meta-analysis

Cited by 13 publications

References 39 publications

Treatment of male stress urinary incontinence at time of inflatable penile prosthesis placement a review of contemporary literature

Treatment of male stress urinary incontinence at time of inflatable penile prosthesis placement a review of contemporary literature

Long-Term Survival Rate of ATOMS Implant for Male Stress Urinary Incontinence and Management of Late Complications

Transversal approach via a bladder neck and prostate combined longitudinal incision versus standard approach of robotic-assisted radical prostatectomy for localized prostate cancer: a retrospective analysis

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