A radical prostatectomy is frequently used as the first-line treatment for men with prostate cancer. Persistent urinary incontinence after surgery is one of the most severe adverse events. We report the results of a comprehensive literature search focused on post-prostatectomy urinary incontinence (PPI), performed by a panel of experts on non-neurogenic lower urinary tract symptoms. The data on the prevalence and timing of PPI are very heterogeneous. The etiology of PPI can be multifactorial and mainly dependent on patient characteristics, lower urinary tract function or surgical issues. The medical history with a physical examination, the use of validated questionnaires with a voiding diary and pad tests are determinants in identifying the contributing factors and choosing the right treatment. Lifestyle intervention and urinary containment are the most frequently used strategies for the conservative management of PPI, while antimuscarinics, beta-3 agonists and duloxetine (off-label) are drugs indicated to manage PPI with a concomitant overactive bladder. Surgical therapies for the management of post-prostatectomy SUI include non-adjustable trans-obturator slings in men with mild-to-moderate incontinence and an artificial urinary sphincter in men with moderate-to-severe incontinence.

Latest Evidence on Post-Prostatectomy Urinary Incontinence / Gacci, Mauro; De Nunzio, Cosimo; Sakalis, Vasileios; Rieken, Malte; Cornu, Jean-Nicolas; Gravas, Stavros. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 12:3(2023), pp. 1-18. [10.3390/jcm12031190]

Latest Evidence on Post-Prostatectomy Urinary Incontinence

De Nunzio, Cosimo;
2023

Abstract

A radical prostatectomy is frequently used as the first-line treatment for men with prostate cancer. Persistent urinary incontinence after surgery is one of the most severe adverse events. We report the results of a comprehensive literature search focused on post-prostatectomy urinary incontinence (PPI), performed by a panel of experts on non-neurogenic lower urinary tract symptoms. The data on the prevalence and timing of PPI are very heterogeneous. The etiology of PPI can be multifactorial and mainly dependent on patient characteristics, lower urinary tract function or surgical issues. The medical history with a physical examination, the use of validated questionnaires with a voiding diary and pad tests are determinants in identifying the contributing factors and choosing the right treatment. Lifestyle intervention and urinary containment are the most frequently used strategies for the conservative management of PPI, while antimuscarinics, beta-3 agonists and duloxetine (off-label) are drugs indicated to manage PPI with a concomitant overactive bladder. Surgical therapies for the management of post-prostatectomy SUI include non-adjustable trans-obturator slings in men with mild-to-moderate incontinence and an artificial urinary sphincter in men with moderate-to-severe incontinence.
2023
ppi; antimuscarinics; artificial urinary sphincter; beta-3 agonists; duloxetine trans-obturator slings; pad test; post prostatectomy incontinence; prostate cancer; radical prostatectomy; robotic prostatectomy; urinary incontinence; voiding diary
01 Pubblicazione su rivista::01g Articolo di rassegna (Review)
Latest Evidence on Post-Prostatectomy Urinary Incontinence / Gacci, Mauro; De Nunzio, Cosimo; Sakalis, Vasileios; Rieken, Malte; Cornu, Jean-Nicolas; Gravas, Stavros. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 12:3(2023), pp. 1-18. [10.3390/jcm12031190]
File allegati a questo prodotto
File Dimensione Formato  
Gaggi_Latest-Evidence-on Post-Prostatectomy_2023.pdf

accesso aperto

Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Creative commons
Dimensione 749.15 kB
Formato Adobe PDF
749.15 kB Adobe PDF

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1669818
Citazioni
  • ???jsp.display-item.citation.pmc??? 0
  • Scopus 7
  • ???jsp.display-item.citation.isi??? 9
social impact