Management of the incontinent patient with a sphincteric stricture following radical prostatectomy

Cox, Ashley; Herschorn, Sender

doi:10.1097/mou.0000000000000116

Cited by 7 publications

(4 citation statements)

References 49 publications

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“…Additionally, four patients (7 %) experienced serious adverse events related to MMC instillation (osteitis pubis, rectourethral fistula with bladder floor necrosis, extensive necrosis of the bladder floor/trigone and pain) [23••]. This reinforces the previous concerns expressed by Cox and Herschorn about the risk of serious adverse events associated with adjuvant MMC injections [24].…”

Section: Endourologic Treatmentsupporting

confidence: 76%

Management Strategies for Post-Prostatectomy Bladder Neck Contractures

Kovell

Terlecki

2015

Curr Urol Rep

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Patients who develop bladder neck contracture (BNC) after surgical treatment for prostate cancer often present with progressive lower urinary tract symptoms. Multiple risk factors contribute to BNC development including patient-related factors and technical considerations at the time of surgery. Initial management begins with endoscopic therapies, including dilation, transurethral incision (TUIBNC), and injection of adjunctive agents. When BNC remains refractory to these therapies, surgical reconstruction of the vesicourethral anastomosis or urinary diversion can be considered in select cases. This review presents an outline of the management of BNC after radical prostatectomy (RP), highlighting the recent literature related to the subject.

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Section: Endourologic Treatmentsupporting

confidence: 76%

Management Strategies for Post-Prostatectomy Bladder Neck Contractures

Kovell

Terlecki

2015

Curr Urol Rep

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“…Literature regarding treatment of male SUI and concomitant bladder neck stricture is currently limited to small case series [14]. Anger et al [15] reported general feasibility of simultaneous stricture incision and AUS implantation without stating the detailed functional outcomes after the implantations.…”

Section: Discussionmentioning

confidence: 99%

Targeting Moderate and Severe Male Stress Urinary Incontinence With Adjustable Male Slings and the Perineal Artificial Urinary Sphincter: Focus on Perioperative Complications and Device Explantations

et al. 2017

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PurposeTo analyze perioperative complications and postoperative explantation rates for selected readjustable male sling systems and the perineal single-cuff artificial urinary sphincter (AUS) in a large, contemporary, multi-institutional patient cohort. MethodsTwo hundred eighty-two male patients who underwent implantation between 2010 and 2012 in 13 participating institutions were included in the study (n=127 adjustable male sling [n=95 Argus classic, n=32 Argus T], n=155 AUS). Perioperative characteristics and postoperative complications were analyzed. The explantation rates of the respective devices were assessed using the Fisher exact test and the Mann-Whitney U-test. A Kaplan-Meier curve was generated. Potential features associated with device explantation were analyzed using a multiple logistic regression model (P<0.05). ResultsWe found significantly increased intraoperative complication rates after adjustable male sling implantation (15.9% [adjustable male sling] vs. 4.2% [AUS], P=0.003). The most frequent intraoperative complication was bladder perforation (n=17). Postoperative infection rates did not vary significantly between the respective devices (P=0.378). Device explantation rates were significantly higher after AUS implantation (9.7% [adjustable male sling] vs. 21.5% [AUS], P=0.030). In multivariate analysis, postoperative infection was a strong independent predictor of decreased device survival (odds ratio, 6.556; P=0.001). ConclusionsComplication profiles vary between adjustable male slings and AUS. Explantation rates are lower after adjustable male sling implantation. Any kind of postoperative infections are independent predictors of decreased device survival. There is no significant effect of the experience of the implanting institution on device survival.

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“…However, there are few data to support this claim; the results of a randomized controlled trial only showed that postoperative incontinence symptoms after RP were significantly improved by preoperative biofeedback combined with postoperative pelvic floor muscle training ( 17 ). The main indications for surgical treatment are patients whose urinary control is still not restored 1 year after RP, and surgical procedures include artificial urethral sphincter implantation, ball cavernous suspension, and transurethral injection of fillers ( 18 – 20 ). However, since post-operative RP patients may suffer from erectile dysfunction and retrograde ejaculation symptoms after surgery, which can affect the quality of life and psychological health of patients.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of mirabegron in the treatment of overactive bladder syndrome after radical prostatectomy: a prospective randomized controlled study

Lin

Xie

et al. 2023

Front. Oncol.

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ObjectivesTo evaluate the effects of mirabegron in the treatment of overactive bladder syndrome (OAB) after radical prostatectomy (RP).Patients and methodsA total of 108 post-operative RP patients were randomly assigned to either the mirabegron (study) or the placebo (control) group. The Overactive Bladder Syndrome Self-Assessment Scale (OABSS) was selected as the primary endpoint, and the International Prostate Symptom Score (IPSS) and Quality of Life (QOL) score were selected as secondary endpoints. Statistical analysis was performed using IBM SPSS Statistics 26, and the treatment effects were compared between the two groups using independent samples t-test.ResultsIn total, 55 patients were included in the study group and 53 patients in the control group. The mean age was(70.08 ± 7.54)years. There was no statistical difference in the baseline data between the two groups. OABSS scores decreased significantly in the study group compared to the control group during drug treatment (6.67 ± 1.06 vs. 9.14 ± 1.83, p < 0.01) and were better than the control group during the follow-up at week 8 and week 12. In addition, the decrease in IPSS scores (11.29 ± 3.89 and 15.34 ± 3.54, p<0.01) and the increase in QOL scores (2.40 ± 0.81 vs. 3.20 ± 1.00) were statistically significant in the study group. And the patients in the study group had better improvement in voiding symptoms and quality of life than the control group during the follow-up period.ConclusionDaily administration of 50 mg mirabegron after RP surgery significantly improved the symptoms of OAB after surgery with fewer side effects. Additional randomized controlled trials should be conducted in the future to further evaluate the efficacy and safety of mirabegron.

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Management of the incontinent patient with a sphincteric stricture following radical prostatectomy

Cited by 7 publications

References 49 publications

Management Strategies for Post-Prostatectomy Bladder Neck Contractures

Management Strategies for Post-Prostatectomy Bladder Neck Contractures

Targeting Moderate and Severe Male Stress Urinary Incontinence With Adjustable Male Slings and the Perineal Artificial Urinary Sphincter: Focus on Perioperative Complications and Device Explantations

Efficacy and safety of mirabegron in the treatment of overactive bladder syndrome after radical prostatectomy: a prospective randomized controlled study

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