Stepwise Approach to Male Urinary Incontinence after Radical Prostatectomy

Hernández Hernández D1, Padilla-Fernández B1, Conde Santos G2, Castro Díaz D1

Research Type

Clinical

Abstract Category

Male Stress Urinary Incontinence (Post Prostatectomy Incontinence)

Abstract 720
Video Session 3 - Male / Wild Card
Scientific Podium Video Session 35
Friday 6th September 2019
16:12 - 16:21
Hall G2
Incontinence Male Surgery Stress Urinary Incontinence
1.Hospital Universitario de Canarias, 2.Hospiten Tenerife
Presenter
B

Bárbara Padilla-Fernández

Links

Abstract

Introduction
Post-prostatectomy urinary incontinence is a frequent problem in prostate cancer survivors regardless of the surgical technique used (open, laparoscopic or robotic), with 5-6% patients requiring surgery for this complication (1)
Design
Basic evaluation of patients with urinary incontinence after radical prostatectomy should include anamnesis and physical examination, 1-3 days voiding diary, 24-hour pad test, urethrocystoscopy and urodynamic study.
Treatment options, once the conservative measures have failed, are fixed slings, adjustable slings, compression devices and artificial sphincters (2)
Results
The decision to use one technique or another will depend on several factors: severity of the incontinence, urethral / sphincter complex status, cognitive level, manual dexterity, patient expectations and surgeon preferences (3)
Conclusion
In our center we use three devices / techniques for the management of post-prostatectomy urinary incontinence:
1. Retrourethral transobturator sling (AdVanceXP)
2. Readjustable suburethral male sling (Remeex)
3. Artificial urinary sphincter (AMS 800 or ZSI 375)
In this video, we present the key steps of each technique.
References
  1. Kim PH, Pinheiro LC, Atoria CL et al: Trends in the use of incontinence procedures after radical prostatectomy: a population based analysis. J Urol 2015; 189: 602.
  2. Herschorn S, Bruschini H, Comiter C et al: Surgical treatment of stress incontinence in men. Neurourol Urodyn 2010; 29: 179.
  3. Bauer RM, Bastian PJ, Gozzi Ch, Stief ChG. Postprostatectomy Incontinence: All About Diagnosis and Management. Eur Urol 2009; 55: 322.
Disclosures
<span class="text-strong">Funding</span> No disclosures <span class="text-strong">Clinical Trial</span> No <span class="text-strong">Subjects</span> None