The management of stress urinary incontinence after radical prostatectomy

Peyromaure, Michaël; Ravery, Vincent; Boccon‐Gibod, Liliane

doi:10.1046/j.1464-410x.2002.02824.x

Cited by 104 publications

(72 citation statements)

References 51 publications

(81 reference statements)

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“…The majority of the authors use the number of pads needed per day, other study groups define urinary continence according to the situation when patients lose urine (laughing, coughing, etc). 2,12,13 We defined patients as fully continent, if no pads were needed. That means that patients who also, used a pad for feeling secure but did not lose any urine at all were regarded as stressincontinent I.1…”

Section: Discussionmentioning

confidence: 99%

Improved urinary continence after radical retropubic prostatectomy with preparation of a long, partially intraprostatic portion of the membraneous urethra: an analysis of 1013 consecutive cases

Randenborgh

Paul

Kübler

et al. 2004

Prostate Cancer Prostatic Dis

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Purpose: To improve the rate of full continence in our patients, we performed, since June 1997, a careful preparation of the distally intraprostatic part of the membranous urethra to obtain a long urethral stump for the vesicourethral anastomosis. Patients and methods: In all, 610 patients without (group 1) and 403 patients with (group 2) a long intraprostatic stump of the urethra were asked by a selfadministered questionnaire about their continence status. The rate of positive surgical margins were compared as a marker of local tumour control. Results: Full continence (no pads) was achieved in 76.02% in group 1 and in 88.84%, of all patients in group 2. Stress incontinence (SIC) I1 was found in 12.46% and 7.44% respectiveley, SIC II1 was noted in 8.69 and 3.72% and complete incontinence was seen in 2.79% in group 1 and in two patients (0.5%) in group 2. Also the time to reach the final continence status was statistically and highly significantly (Po0.001) shortened. The rate of positive margins decreased in group 2, despite intraprostatic preparation. Conclusions: The preparation of a long, partially intraprostatic portion of the membranous urethra for vesicourethral anastomosis in radical retropubic prostatectomy leads to a statistically highly significant improvement of full continence and earlier continence in prostate cancer patients without compromising local tumour control.

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Section: Discussionmentioning

confidence: 99%

Improved urinary continence after radical retropubic prostatectomy with preparation of a long, partially intraprostatic portion of the membraneous urethra: an analysis of 1013 consecutive cases

Randenborgh

Paul

Kübler

et al. 2004

Prostate Cancer Prostatic Dis

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“…In 3 randomized controlled trials, PFMT after RP was evaluated using the IIQ-7 to assess patient QQL (2,9,15). In none of the studies, the QOL improved in the treatment group, even in one that revealed better continence in the treatment group.…”

Section: Discussionmentioning

confidence: 99%

“…UI develops in the majority of patients during the early postoperative days. Peyromaure et al (2) emphasized that early UI affects 30% to 50% of patients from 3 weeks to 6 months after RP. Rates vary widely due to survey methods, the definition of incontinence and surgical technique.…”

Section: Introductionmentioning

confidence: 99%

Radikal Prostatektomi Sonrası Üriner İnkontinansın Düzelmesinde Pelvik Tabanda Biofeedback ve Elektrik Stimülasyonunun Etkisi

Ahmed¹,

Mohammed²,

Amansour³

2012

tftr

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Objective: Urinary incontinence (UI) is one of the most distressing postoperative problems of radical prostatectomy (RP) and negatively affects the quality of life (QOL). We assessed the effect of pelvic muscle exercises (PME), electrical stimulation (ES) and biofeedback (BFB) on UI after RP. Materials and Methods: 80 patients, who underwent RP, were randomized into three groups. Group I (n=26) received instructions about PME, group II (n=26) received ES and group III (n=28) received ES plus BFB. The treatment was started one week after catheter removal, twice a week for 12 weeks. The evaluation of continence was performed at time 0, 6, 12 weeks, and 24 weeks during follow-up, using the 24-hour pad test and the QOL using the incontinence impact questionnaire -7 (IIQ-7). Results: The mean leakage weight became significantly lower (p<0.05) in group III than in groups II and I starting at 6 weeks until 24 weeks of follow-up. A significant difference (p<0.05) between the groups in terms of percentage of continent patients was achieved from 12 weeks (71.42%, 53.85% and 34.62%) to 24 weeks (96.43%, 76.92% and 65.38%) for groups III, II and I, respectively. Conclusion: Early, noninvasive therapy with ES and BFB has a significant positive effect on the duration and the degree of UI and QOL. Turk J Phys Med Re hab 2012;58:170-6. Key Words: Urinary incontinence; radical prostatectomy; electrical stimulation; biofeedback Özet Amaç: Üriner inkontinans (Üİ) radikal prostatektominin (RP) en sıkıntı verici ameliyat sonrası komplikasyonlarından olup, yaşam kalitesini (YK) olumsuz etkiler. Bu çalışmada pelvik kas egzersizleri (PKE), elektrik stimülasyonu (ES) ve biofeedback (BFB) uygulamasının RP sonrası Üİ üzerindeki etkisini araştırdık. Gereç ve Yöntem: RP geçirmiş 80 hasta üç gruba randomize edildi. Grup I e (n=26) PKE, Grup II'ye (n=26) ES ve Grup III'e (n=28) ES artı BFB verildi. Kateterin çıkarılmasından bir hafta sonra başlanan tedavi on iki hafta boyunca haftada iki gün uygulandı. 0, 6, 12 ve 24. haftalardaki takip sırasında kontinans 24 saatlik ped testi ile yaşam kalitesi ise inkontinans etki anketi-7 (IIQ-7) ile değerlendirilmiştir. Bulgular: Grup I de, altıncı haftadan başlayarak 24 üncü hafta takiplerine kadar görülen ortalama sızıntı miktarı Grup I ve II ye göre önemli ölçüde daha azdı. Gruplarda kontinans oranı bakımından 12. haftada (Grup III, II ve I için sırasıyla %71,42, %53,85 ve %34,62) ve 24 üncü haftada (%94,43, %76,92 ve %65,38) önemli farklara ulaşıldı. Sonuç: ES ve BFB ile erken noninvaziv terapinin Üİ süresi ve derecesi ile YK üzerinde önemli bir etkisi bulunmaktadır. Türk Fiz T›p Re hab Derg

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“…Persistent incontinence negatively affects the post-operative quality of life and is of more concern than erectile dysfunction, especially in older patients [2]. Peyromaure et al reported that early UI affects 30% to 50% of patients from 3 weeks to 6 months after RP [3]. Post prostatectomy incontinence (PPI) is demonstrated widely, ranging from slight leakage with heavy lifting to continuous or gravitational leakage requiring multiple pads or even a penile clamp [4].…”

Section: Introductionmentioning

confidence: 99%

Impact of Therapeutic Electrical Stimulation of Sacral Surface Considering Individual Anatomical Sacral Variations on Early Recovery Urinary Continence after Radical Prostatectomy

ElSawy¹,

Mahran²,

Al-Kushi³

2017

FMAR

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Objectives: To investigate the effect of electrical stimulation of different anatomical variations of sacral surface on early recovery of urinary continence after radical prostatectomy. Methods: Twenty of 53 consecutive patients who underwent prostatectomy by a single surgeon were enrolled in this study. Ten patients were prospectively randomized to two groups; five patients in Sacral foramena stimulation group received postoperative surface electrical stimulation of sacral foramina area while five patients in control group did not received any electrical stimulation. Selection of remaining ten patients depended on sacral hiatus anatomical variations, assessed by plan X-rays. Of the ten patients, five patients with sacral hiatus subtotals were grouped under SHS1 while 5 patients with sacral hiatus totals were grouped as SHS2. Electrical stimulation for each group began 7 days after catheter removal, thrice a week for 8 weeks. Each of the 24 treatment sessions for each group composed of 20 minutes for sacral electrical stimulation. Continence was evaluated at baseline, 4 and 8 weeks using the 24-hour pad test and according to the incontinence section of the International Continence Society questionnaire. Results: After 2 weeks of treatment, the mean leakage weight was comparable between SFS group and SHS1 group while it was significantly lowered in SHS2 as compared to SFS and SHS1 groups. Comparing mean leakage weight at 8 weeks revealed further significant reduction in SHS2 group than in SFS and SHS1 groups. Moreover, percentage of continent patients was highest in SHS2 2group after 8 weeks of treatment followed by SHS1, SFS and control respectively. Conclusions: Electrical stimulation of sacral hiatus surface area may provide better stimulation for sacral nerve than sacral foramena surface area and appears to be effective treatment for early recovery of urinary continence after radical prostatectomy.

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The management of stress urinary incontinence after radical prostatectomy

Cited by 104 publications

References 51 publications

Improved urinary continence after radical retropubic prostatectomy with preparation of a long, partially intraprostatic portion of the membraneous urethra: an analysis of 1013 consecutive cases

Improved urinary continence after radical retropubic prostatectomy with preparation of a long, partially intraprostatic portion of the membraneous urethra: an analysis of 1013 consecutive cases

Radikal Prostatektomi Sonrası Üriner İnkontinansın Düzelmesinde Pelvik Tabanda Biofeedback ve Elektrik Stimülasyonunun Etkisi

Impact of Therapeutic Electrical Stimulation of Sacral Surface Considering Individual Anatomical Sacral Variations on Early Recovery Urinary Continence after Radical Prostatectomy

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