Post‐prostatectomy urinary incontinence: a review of surgical treatment options

Wilson, L.; Gilling, Peter

doi:10.1111/j.1464-410x.2011.10052.x

Cited by 41 publications

(27 citation statements)

References 26 publications

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“…Our analysis showed a cure rate of about 60% and an improvement rate of 25%. The artificial urinary sphincter also has the advantage of being versatile and effective for a wide range of conditions including after failure of other treatments and radiation [46]. …”

Section: Discussionmentioning

confidence: 99%

Surgical treatment for urinary incontinence after prostatectomy: A meta-analysis and systematic review

et al. 2017

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BackgroundThis meta-analysis was designed to assess the efficacy of the male sling and artificial urinary sphincter on treating post-prostatectomy incontinence by evaluating daily pad use, cure rate, frequency of improvement in incontinence, and quality of life.MethodsMedline, Cochrane, Google Scholar, and ClinicalTrials.gov were searched (until March 31, 2014) for studies that investigated the effectiveness of artificial urinary sphincter or sling surgical treatments for prostate cancer. The primary outcome was daily pad use before and after surgery and secondary outcomes were quality of life before and after surgery, and frequency of cures (no need to use of a pad for at least 1 day) and improvements (decreased pad usage) in incontinence after surgery.ResultsWe found that that both the sling and artificial urinary sphincter significantly decreased the number of pads used per day by about 3 (P-values <0.001) and increased the quality of life compared with before intervention (P-values < 0.001). In addition, the cure rate and was around 60%. Intervention resulted in improvement in incontinence by about 25% (P < 0.001).ConclusionOur findings indicate that both sling and artificial urinary sphincter interventions are effective in reducing incontinence and improving the patient’s quality of life.

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Section: Discussionmentioning

confidence: 99%

Surgical treatment for urinary incontinence after prostatectomy: A meta-analysis and systematic review

et al. 2017

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“…The prevalence of post‐prostatectomy urinary incontinence (PPI) in men varies widely depending on the definitions used, questions asked, and population sampled. The prevalence rates have been reported to be as high as 80%, although the requirement for surgical intervention is between 4% and 8% …”

Section: Introductionmentioning

confidence: 99%

Can filling phase urodynamic parameters predict the success of the bulbar artificial urinary sphincter in treating post‐prostatectomy incontinence?

Solomon

Veeratterapillay

Malde

et al. 2016

Neurourology and Urodynamics

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Sixty-eight percent (n = 68) of patients had a successful outcome. The mean compliance for the "success" and "failure" group was 112.3 mL/cmH O (±119.7) and 34.1 mL/cmH O (±36.2), respectively. Fifty-five percent (17/31) of patients in the "failure" group demonstrated DO(P = 36.2 ± 18.2 cmH O) compared to 18% (12/68) in the success group. The differences between the two groups in P and compliance were statistically significant (all P < 0.01). There was, however, no statistical difference between the mean cystometric capacities of patients in the two outcome groups. Thirteen out of 18 (72%) patients who had radiotherapy had a poor outcome ("success" group only 15% [9/59]). These results were used to develop a nomogram for the probability of AUS success. A good inverse correlation (r = -0.65) was demonstrated between the probability of AUS success as deduced from the nomogram and PGI-I score post-AUS implantation CONCLUSION: Compliance and P are predictors of outcome following AUS implantation for PPI. We have developed and internally validated a nomogram that may be used to determine an individualized likelihood of AUS success. This nomogram may be used as a counseling tool to objectively set realistic expectations of continence post-AUS implantation.

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“…The two most common surgical techniques are the male sling and artificial urinary sphincter (AUS). 3 The AUS was introduced in 1972 (AMS, Minnetonka, MN). 4 It is still considered the current gold standard for the management of PPI with excellent long-term 5-year continence rates.…”

Section: Introductionmentioning

confidence: 99%

Stemming the tide of mild to moderate post-prostatectomy incontinence: A retrospective comparison of transobturator male slings and the artificial urinary sphincter

Hoy

Rourke

2014

CUAJ

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Introduction: The AUS remains the gold standard treatment for post-prostatectomy incontinence (PPI), although most patients with mild-moderate PPI prefer a sling without strong evidence of procedural equivalence. This study compares outcomes of 2 procedures for the treatment of mild-moderate PPI. Methods: A retrospective review of 124 patients (76 transobturator sling, 48 AUS) with mild-moderate PPI requiring intervention over an 8-year period. The primary outcome was continence. Secondary outcomes included global patient satisfaction, improvement, and complication rates. Mild to moderate incontinence was defined as requiring ≤5 pads/day. Results: There was no significant difference in age (66.2 vs. 68.1 years; p = 0.17) or prostate cancer characteristics for slings and AUS, respectively. AUS patients had higher Charlson comorbidity scores and were more likely to have previous radiotherapy. Median length of follow up was 24 months for slings and 42 months for AUS. There was no difference in continence rates, 88.2% vs. 87.5% (p = 0.79), rate of improvement, 94.7% vs. 95.8% (p = 1.00), or patient satisfaction, 93.4% vs. 91.7% (p = 0.73), for slings and AUS, respectively. Complication rates were equivalent (19.7% vs. 16.7%; p = 1.00), though a significantly higher proportion of complications with AUS were Clavien Grade 3 (0% vs. 75%; p = 0.006). Conclusions: For mild to moderate PPI there is no difference in continence, satisfaction, or improvement rates, between AUS and slings. AUS complications tend to be more severe. Our study supports the use of slings as first-line treatment for mild-moderate PPI.

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Post‐prostatectomy urinary incontinence: a review of surgical treatment options

Cited by 41 publications

References 26 publications

Surgical treatment for urinary incontinence after prostatectomy: A meta-analysis and systematic review

Surgical treatment for urinary incontinence after prostatectomy: A meta-analysis and systematic review

Can filling phase urodynamic parameters predict the success of the bulbar artificial urinary sphincter in treating post‐prostatectomy incontinence?

Stemming the tide of mild to moderate post-prostatectomy incontinence: A retrospective comparison of transobturator male slings and the artificial urinary sphincter

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