Contemporary management of postprostatectomy incontinence.

Overview

CONTEXT: In recent years, despite improvement in the surgical technique, the prevalence of postprostatectomy incontinence has increased due to a rise in the number of radical prostatectomies performed annually. OBJECTIVE: The aim of this review is to evaluate contemporary noninvasive and invasive treatment options for postprostatectomy incontinence. EVIDENCE ACQUISITION: In August 2010, a review of the literature was performed using the Medline database. EVIDENCE SYNTHESIS: All articles concerning noninvasive and invasive treatment for postprostatectomy incontinence were included. CONCLUSIONS: No randomised controlled trials exist to compare currently used noninvasive and invasive treatments for postprostatectomy incontinence. Pelvic floor muscle training is recommended for the initial treatment of stress urinary incontinence (SUI). Additionally, antimuscarinic therapy should be applied for urgency or urge incontinence. For decades, the artificial urinary sphincter was the reference standard for persistent SUI. Nowadays, male slings are an alternative for men with mild to moderate postprostatectomy SUI.