Sexual Health

June 2009

Clinical

Postprostatectomy stress urinary incontinence

Current and evolving therapies

Volume 38, No.6, June 2009 Pages 399-404

Ian A R Smith

Elizabeth Shaw

Prem Rashid

Background

Postprostatectomy stress urinary incontinence (PPSUI) is a clinically significant problem with an incidence of 3–60%.

Objective/s

This article discusses the indications and efficacy of current and evolving surgical therapies for PPSUI as a guide for general practitioners.

Discussion

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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Correspondence afp@racgp.org.au

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