Ian A R Smith
Postprostatectomy stress urinary incontinence (PPSUI) is a clinically
significant problem with an incidence of 3–60%.
This article discusses the indications and efficacy of current
and evolving surgical therapies for PPSUI as a guide for general
Surgical intervention can be considered for bothersome PPSUI
persisting longer than 12 months for which conservative therapy has
failed. Careful preoperative assessment and counselling is necessary
to select appropriate candidates for surgical intervention. When
considering the success of various therapies for PPSUI, patient
satisfaction is often related to the magnitude of incontinence pad
reduction, rather than absolute pad usage per day. Currently, there
are several surgical therapies available for PPSUI including bulking
agents, the artificial urinary sphincter (AUS-800®) and male sling
devices. The AUS-800® remains the gold standard for moderate to
severe PPSUI, however, sling devices demonstrate promising short to
intermediate term results.
Following a radical prostatectomy, 3–60% of men will suffer from postprostatectomy stress urinary incontinence (PPSUI ).1–3 Although mild in most instances, 4% of men will suffer significant leakage necessitating pad usage.2
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