Pharmacological Treatment of Post-Prostatectomy Incontinence: What is the Evidence?

Abstract

Urinary incontinence is a common and debilitating problem, and post-prostatectomy incontinence (PPI) is becoming an increasing problem, with a higher risk among elderly men. Current treatment options for PPI include pelvic floor muscle exercises and surgery. Conservative treatment has disputable effects, and surgical treatment is expensive, is not always effective, and may have complications. This article describes the prevalence and causes of PPI and the current treatment methods. We conducted a search of the PUBMED database and reviewed the current literature on novel medical treatments of PPI, with special focus on the aging man. Antimuscarinic drugs, phosphodiesterase inhibitors, duloxetine, and α-adrenergic drugs have been proposed as medical treatments for PPI. Most studies were small and used different criteria for quantifying incontinence and assessing treatment results. Thus, there is not enough evidence to recommend the use of these medications as standard treatment of PPI. To determine whether medical therapy is a viable option in the treatment of PPI, randomized, placebo-controlled studies are needed that also assess side effects in the elderly population.

Prä-, intra- und postoperative Einflussfaktoren funktioneller Einschränkungen nach radikaler Prostatektomie

“…Im Zentrum der Therapie stehen physiotherapeutische Maßnahmen; daneben werden multimodale Konzepte verfolgt. Der pathophysiologische Mecha- [46]. In welchem Umfang konservative Maßnahmen die Langzeitergebnisse der Postprostatektomiekontinenz überhaupt beeinflussen, wird kritisch diskutiert [47].…”

Management of Urinary Incontinence Following Radical Prostatectomy: Challenges and Solutions

“…Surgical treatments include bulking agents use, artificial urinary sphincter implants, retrourethral transobturator slings, and adjustable male sling systems. 9 , 10 …”