Management of Postradical Prostatectomy Urinary Incontinence: A Review

Radadia, Kushan; Farber, Nicholas; Shinder, Brian; Polotti, Charles F.; Milas, Lee J.; Tunuguntla, Hari Siva Gurunadha Rao

doi:10.1016/j.urology.2017.09.025

Cited by 57 publications

(70 citation statements)

References 48 publications

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“…Urinary incontinence (UIN) is a common and established complication of radical prostatectomy (RP) 1 . Although the oncologic outcome is the most important goal of RP, UIN after RP has a negative effect on health‐related quality of life (QoL).…”

Section: Introductionmentioning

confidence: 99%

Correlation between lumbar skeletal muscle size and urinary incontinence after radical prostatectomy

Mitsui

Sadahira

Watanabe

et al. 2020

LUTS

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Objectives Urinary incontinence is a major concern after radical prostatectomy because it can decrease quality of life. The aim of the present study was to explore the effect of preoperative skeletal muscle on urinary quality of life after robot‐assisted radical prostatectomy. Methods A total of 762 patients underwent robot‐assisted radical prostatectomy. Longitudinal health‐related quality of life was evaluated using the Expanded Prostate Cancer Index Composite instrument. The skeletal muscle area at the level of the third lumbar vertebra was assessed preoperatively by computed tomography and was standardized to height to obtain the skeletal muscle index. Reduced skeletal muscle size (RSMS) was defined as a skeletal muscle index ≤ 53 or ≤ 43 cm2/m2 in patients with a body mass index (BMI) ≥25 or < 25, respectively. Results A total of 301 patients were included in this study, of whom 91 were classified as having RSMS (30.2%). Non‐RSMS patients exhibited better urinary function at 12 months (P = .012) and better urinary continence recovery at 2 weeks and 12 months (P = .033 and P = .014, respectively) after prostatectomy compared with RSMS patients. Univariate and multivariate analyses identified preoperative RSMS as a significant and independent predictor of urinary incontinence (odds ratio = 1.77, P = .028). Conclusions Patients with RSMS had a lower urinary quality of life compared with non‐RSMS patients after robot‐assisted radical prostatectomy, and RSMS, independent of age or BMI, was predictive of postoperative urinary incontinence.

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Section: Introductionmentioning

confidence: 99%

Correlation between lumbar skeletal muscle size and urinary incontinence after radical prostatectomy

Mitsui

Sadahira

Watanabe

et al. 2020

LUTS

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“…Nevertheless, complications of bladder neck contraction and urinary incontinence, which were common after RP, could be circumvented in the patients who received cystoprostatectomy [30]. In the context of that, several patients after RP would suffer from severe incontinence for a long time without effective treatment [45,46]. Otherwise, personal symptoms and discomforts would generally be improved after cystoprostatectomy, especially hematuria and dysuria caused by tumor invasion of the bladder neck.…”

Section: Clinical Characterizations and Outcomes Of Cystoprostatectommentioning

confidence: 99%

The role of cystoprostatectomy in management of locally advanced prostate cancer: a systematic review

et al. 2020

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Background: The role of cystoprostatectomy for the treatment of locally advanced prostate cancer (LAPC) was evaluated by a comprehensive review of contemporary literatures. Methods: A systematic search of English language literatures using PubMed, EMBASE, Web of Science, and Cochrane library, from 1990 to 2018, was performed. Two independent authors reviewed abstracts as well as fulltext articles and extracted data from the selected manuscripts. Results: After the literature research, seven articles with a total of 211 patients were identified. Both 120 cases who received cystoprostatectomy for the primary treatment of LAPC and 91 cases for the salvage surgery after local recurrence were finally included. Overall incidence of positive surgical margins ranged from 25 to 78%. The incidence of major complications caused by the surgery during the follow-up time was limited. It had been reported that among LAPC patients who received cystoprostatectomy combined with adjuvant therapies, 5-year cancer-specific survival rate and 5-year biochemical progression-free survival was up to 87.1% and 62.2%. Moreover, symptoms such as hematuria and other urination dysfunctions, as well as patients' quality of life were significantly improved after cystoprostatectomy in LAPC patients with the bladder invasion. Conclusions: Cystoprostatectomy can serve as an alternative to the surgical step of multimodal therapy for highly selected LAPC patients with the bladder invasion, which may improve patients' symptoms and related quality of life. Therefore, cystoprostatectomy as an option for the treatment of LAPC with the bladder invasion may be feasible and safe with considerable survival outcomes.

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“…Stress urinary incontinence (SUI) is an involuntary loss of urine during physical exertion or physical activity [6]. Men who have undergone surgical treatment or radiation therapy for prostatic conditions, such as an enlarged prostate or cancer, have an increased risk of developing SUI [7]. Men who undergo multiple prostatic treatments have a substantially higher risk of developing SUI when compared to those who have only undergone a single treatment modality.…”

Section: Male Stress Urinary Incontinence (Sui)mentioning

confidence: 99%

Medical evaluation and management of male and female voiding dysfunction: a review

Murphy

Teplitsky

Das

et al. 2019

Romanian Journal of Internal Medicine

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A significant workforce shortage of urologists available to serve the US population has been projected to occur over the next decade. Accordingly, much of the management of urologic patients will need to be assumed by other specialties and practitioners. Since primary care physicians are often first evaluate common urologic complaints, it makes sense that these physicians are in an excellent position to intervene in the management of these patients when appropriate. One of the most common complaints in urology is voiding dysfunction. The incidence of voiding dysfunction increases with age, with conservative estimates showing that over 50% of elderly patients suffer. Despite this high prevalence and its negative impact on quality of life, however, few seek or receive treatment, as many do not readily disclose these impactful yet personal symptoms. We sought to summarize the typical presentation, evaluation, assessment and therapeutic options for both male and female patients presenting with voiding dysfunction.

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Management of Postradical Prostatectomy Urinary Incontinence: A Review

Cited by 57 publications

References 48 publications

Correlation between lumbar skeletal muscle size and urinary incontinence after radical prostatectomy

Correlation between lumbar skeletal muscle size and urinary incontinence after radical prostatectomy

The role of cystoprostatectomy in management of locally advanced prostate cancer: a systematic review

Medical evaluation and management of male and female voiding dysfunction: a review

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