Post prostatektomi inkontinans: Nasıl tedavi edelim?

  • Ahmet Rüknettin Aslan
  • Feridun Şengör

Bull Urooncol 2010;9(2):69-73

Although the urinary incontinence may be seen after any kind of prostatic operation, post-prostatectomy incontinence has entered to urological armamentarium only after the rise at the radical prostatectomy cases. Trend towards the robot-assisted or laparoscopic surgical techniques was unable to diminish postprostatectomy rates. A cumulatively rising incontinent male population, despite poor quality of life parameters, is a huge burden to the healthcare system due to the diagnostic and therapeutic expenses. Pre and perioperative factors seem to be the main reason in the pathophysiology of the post-prostatectomy incontinence. This may show that we can prevent this so-called iatrogenic problem.Although detrusor instability may accompany many of the cases, video-urodynamic studies show the absolute role of sphincteric incompetency. It is difficult to interpret studies due to the lack of consensus in the terminology. Retrospective studies or lack of randomization is a major drawback in the use of evidence base medicine in this field. Despite their limited success, medical therapies are widely used in prostatectomy incontinence. Since his first appearance in the market, artificial urinary sphincter remains to be the gold standard in the therapy of sphincteric incontinence. Although not better than artificial urinary sphincter, male slings have promising results and are the preferred therapy options by many centers.