Urologie pro praxi 4/2022

Treatment of stress urinary incontinence in men after prostate surgery

Male stress urinary incontinence (SUI) is common complication after radical surgery for prostate cancer. Patient´s individual features should be well kept in mind, with the aim of better assessing the individual risk of SUI. Therapy of post-prostatectomy SUI (PPSUI) can be difficult. If conservative management fails, surgical options can be used. Several surgical procedures are currently available to treat PPSUI. Out of these, artificial urinary sphincter (AUS) showed the longest record of safety and efficacy for patients with moderate to severe SUI. Male slings are an alternative approach for men with mild to moderate SUI. Other less popular options, such as injectable bulking agents or adjustable balloons should only be considered when more established procedures are contraindicated. PPSUI is one of the few urologic diseases that is iatrogenic, and therefore predictable and perhaps preventable.

Keywords: PPSUI, pathophysiology, risk factors, diagnosis, treatment, prevention.