The management of stress urinary incontinence after radical prostatectomy
Article first published online: 24 JUN 2002
Volume 90, Issue 2, pages 155–161, July 2002
How to Cite
Peyromaure, M., Ravery, V. and Boccon-Gibod, L. (2002), The management of stress urinary incontinence after radical prostatectomy. BJU International, 90: 155–161. doi: 10.1046/j.1464-410X.2002.02824.x
- Issue published online: 24 JUN 2002
- Article first published online: 24 JUN 2002
Up to 30% of patients complain about urine leakage after radical prostatectomy, but persistent stress incontinence (beyond 1 year) affects <5% of them. This complication is mainly caused by sphincter dysfunction. Some preventive measures have been described to decrease the risk of incontinence after radical prostatectomy, but with conflicting results. The effectiveness of preoperative and early postoperative physiotherapy is controversial. Moreover, while meticulous apical dissection of the prostate significantly improves postoperative continence, the benefit of other surgical techniques, e.g. preserving the bladder neck and the neurovascular bundles, is under debate. The treatment of persistent stress urinary incontinence is mainly based on surgery, as this type of incontinence usually does not respond to physiotherapy and anticholinergic medication. While injection therapy is safe and well tolerated, its effect on postoperative continence is limited and decreases with time. The best results are achieved by implanting an artificial urinary sphincter, but with significant complication and revision rates.