INTRODUCTION:
Regardless of the technique used, the most frequent cause of male stress urinary incontinence (MUI) continues to be radical prostatectomy for prostate adenocarcinoma. The pathophysiological mechanism of MUI lies in the primary injury to the periurethral sphincter and/or in the destruction of the supporting structures.
There is a high percentage of patients with continence problems, being lower those with moderate/severe incontinence, but continuing to be a high percentage (1).
Genitourinary toxicity after radiotherapy consists in acute symptoms, generally self-limiting, irritative symptoms predominate, including increased urinary frequency, dysuria and/or urgency due to cystitis, urethritis or both (2), sometimes incontinence appears accompanied by urinary urgency in the context of an overactive bladder. The risk of urinary incontinence after TEN can generally be considered very low with rates of 0-10% depending on the definition used (3).

OBJECTIVES: To know the results of the treatment of male urinary incontinence (MUI) in patients who have received radiotherapy (RT) after radical prostatectomy (RP) for the treatment of prostate cancer and the factors that influence them.

A retrospective multicentre study of 226 patients treated with RP plus RT who are implanted with a device to correct the MUI. Groups: GA (n = 137): successful result = total continence. GB (n = 89): failure result = incontinence. Subgroups: "s" ("success": a year continues with urinary continence or they get it; Subgroup "f" ("failure"): a year they continue with MUI or recurrence. Variables: Age, BMI, PSA, TNM, Gleason, prostate volume, follow up time, secondary diagnoses (DDSS), history, device: Transobturator suburethral tape (TOT), intraurethral adjustable suburethral tape (ATOMS® or PHORBAS®), or suprapubic level adjustable suburethral tape (REMEEX®), MUI grading Descriptive statistics, ANOVA analysis, Student's t-test, Fisher's exact test, multivariate analysis, p <0.05 was considered significant.

Media age 69 y.o. (59-82), younger in GA. The time between diagnosis of MUI and corrective surgery: media 7 years, in GA less than GB (p = 0.0006); In GA, GAs was lower than GAf; GAs lower than GBe. Medical DDSS in GA greater comorbidity in GAf versus GAs. In GA more surgical history in GAf versus GAs. In GB more arterial hypertension, diabetes mellitus, anxiety and depression in GBf compared to GBs. History of prostate adenomectomy plus in GAf (83%) versus GBf (5%). There are no differences between TOT and REMEEX® in GA. Adjustable suburethral tapes (ATOMS® or PHORBAS®): more cases in GAf (table1).

Some patients with ATOMS were rescued in second time. If REMEEX® device fails to start, it is better to switch to artificial urinary sphincter.

MUI treatment after PR + RT with suburethral anti-incontinence devices have an initial success rate of 60.66% and in the second time, they reach 82.74%. Younger patients have a better prognosis. BMI, PSA or prostate volume do not influence the outcome, unlike Gleason, longer MUI evolution time, pre-PR LUTS and more DDSS, which are associated with failure.

Graham J, Kirkbride P, Cann K, Hasler E, Prettyjohns M. Prostate cancer: summary of updated NICE guidance. Bmj. 2014;348:f7524.
Dearnaley DP, Hall E, Lawrence D, Huddart RA, Eeles R, Nutting CM, et al. Phase III pilot study of dose escalation using conformal radiotherapy in prostate cancer: PSA control and side effects. British journal of cancer. 2005;92(3):488-98.
Beckendorf V, Guerif S, Le Prise E, Cosset JM, Lefloch O, Chauvet B, et al. The GETUG 70 Gy vs. 80 Gy randomized trial for localized prostate cancer: feasibility and acute toxicity. International journal of radiation oncology, biology, physics. 2004;60(4):1056-65.