The use of urethral bulking injections in post‐prostatectomy stress urinary incontinence: A narrative review of the literature

Nguyen, Linh; Leung, Lap Yan; Walker, Roger; Nitkunan, Tharani; Sharma, Divya; Seth, Jai

doi:10.1002/nau.24143

Cited by 11 publications

(6 citation statements)

References 51 publications

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“…Injections of bulking agents were often used in men after post-prostatectomy incontinence [ 76 ]. Our own sobering experiences coincide with the literature: the outcome of bulking agents in patients with incontinence after radical prostatectomy is poor [ 88 ]. Although the procedure impresses with low invasiveness, the long-term successes, in particular, seem low.…”

Section: Surgical Treatment Of Stress Urinary Incontinencesupporting

confidence: 65%

Stress Urinary Incontinence: An Unsolved Clinical Challenge

Harland,

Walz,

Eberli

et al. 2023

Biomedicines

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Stress urinary incontinence is still a frequent problem for women and men, which leads to pronounced impairment of the quality of life and withdrawal from the social environment. Modern diagnostics and therapy improved the situation for individuals affected. But there are still limits, including the correct diagnosis of incontinence and its pathophysiology, as well as the therapeutic algorithms. In most cases, patients are treated with a first-line regimen of drugs, possibly in combination with specific exercises and electrophysiological stimulation. When conservative options are exhausted, minimally invasive surgical therapies are indicated. However, standard surgeries, especially the application of implants, do not pursue any causal therapy. Non-absorbable meshes and ligaments have fallen into disrepute due to complications. In numerous countries, classic techniques such as colposuspension have been revived to avoid implants. Except for tapes in the treatment of stress urinary incontinence in women, the literature on randomized controlled studies is insufficient. This review provides an update on pharmacological and surgical treatment options for stress urinary incontinence; it highlights limitations and formulates wishes for the future from a clinical perspective.

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Section: Surgical Treatment Of Stress Urinary Incontinencesupporting

confidence: 65%

Stress Urinary Incontinence: An Unsolved Clinical Challenge

Harland,

Walz,

Eberli

et al. 2023

Biomedicines

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“…Despite the known low efficacy, bulking agents are still one of the most used incontinence therapies utilized by urologists ( 18 ). This is likely attributed to the minimally invasive nature and low complication risk of the procedure ( 19 ).…”

Section: Managementmentioning

confidence: 99%

Treatment of male stress urinary incontinence at time of inflatable penile prosthesis placement a review of contemporary literature

Elbakry,

O’Connor,

Yafi

et al. 2024

Transl Androl Urol

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Background and Objective Male stress urinary incontinence (SUI) and erectile dysfunction (ED) are well established diagnoses within Men’s Health, often more specifically within the prostate cancer survivorship cohort. Taken individually, well defined treatment algorithms exist with which many surgeons are comfortable; however, treatment of both in a single setting or staged fashion introduces complexity. Emerging treatment options also exist, and there is immature or minimal data when these are combined with inflatable penile prosthesis (IPP) insertion, radiation history, and/or variable degrees of incontinence. Our objective was to describe and summarize the currently available treatment options for SUI particularly at the time of IPP insertion. Methods A literature review was performed to summarize contemporary treatment of SUI at time of IPP placement. Anecdotal experience was added from high volume, subspecialty trained Men’s Health and Reconstructive Urologists. Key Content and Findings Non-invasive approaches such as pelvic floor muscle training (PFMT), behavioral modification, and external compression devices play some limited role in treatment and/or management of SUI, particularly in the early post operative period, or for those unwilling or unable to undergo more definitive intervention. More invasive options such as artificial urinary sphincter (AUS) implantation, male sling, or other implantable devices are more appropriate for good surgical candidates with higher bother and/or more severe incontinence. These options can be concomitant or staged relative to IPP placement. Climacturia, particularly with mild or no bothersome SUI, can successfully be addressed at the time of penile prosthesis placement with the utilization of the Mini-Jupette suburethral sling. Conclusions A variety of treatment options exist for concomitant treatment of SUI at time of IPP, and both safety and efficacy have been demonstrated for many in the same operative setting. As with treatment of ED or SUI in isolation, patient selection, careful counseling, and management of expectations can lead to high patient satisfaction.

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“…, collagen, teflon, silicone, autologous tissues, hyaluronic acid) have been used. In a recent meta-analysis of 25 studies, the success rates varied widely from 13% to 100% [ 105 ]. Due to poor clinical evidence base, further research is required and this approach should therefore be considered when other more established treatments are contraindicated.…”

Section: Main Bodymentioning

confidence: 99%

How to Prevent and Manage Post-Prostatectomy Incontinence: A Review

Schifano

Capogrosso

Tutolo

et al. 2021

World J Mens Health

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Purpose To provide an overview of the currently available evidence relating to the prevention and management strategies of urinary incontinence (UI) after radical prostatectomy (RP). Materials and Methods A comprehensive research was carried out on MEDLINE/PubMed database to identify pertinent studies concerning post-RP UI. The search strategy included these words: urinary continence; urinary continence recovery; urinary incontinence; radical prostatectomy; and prostate cancer. Results Post-RP UI still represents a challenging issue for both urologic patients and clinicians. A complete preoperative assessment of the risk factors associated with post-RP UI aids both in counseling those patients with a higher estimated likelihood of postoperative UI and in identifying those who would probably benefit from preventive strategies in the preoperative and in the intraoperative settings. Over the last decades different surgical strategies based on either the “preservation” or the “reconstruction” of the anatomical elements responsible for urinary continence (UC) led to an overall improvement of postoperative functional outcomes. Finally, several therapeutic strategies should be evaluated for the postoperative UI management. Artificial urinary sphincter implantation represents the gold standard for treatment, notwithstanding its wide adoption is limited due to high costs and significant risk of surgical revision. In this context, male sling positioning seems the most promising strategy, in particular in mild and moderate post-RP UI. Conclusions To enhance the likelihood of obtaining an optimal UC recovery after RP, it is here strongly suggested to intervene throughout the overall clinical management process thus including the pre-, intra- and postoperative settings.

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The use of urethral bulking injections in post‐prostatectomy stress urinary incontinence: A narrative review of the literature

Cited by 11 publications

References 51 publications

Stress Urinary Incontinence: An Unsolved Clinical Challenge

Stress Urinary Incontinence: An Unsolved Clinical Challenge

Treatment of male stress urinary incontinence at time of inflatable penile prosthesis placement a review of contemporary literature

How to Prevent and Manage Post-Prostatectomy Incontinence: A Review

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