Skip to main content
SpringerLink
Log in

Post-Prostatectomy Incontinence

  • Chapter
Voiding Dysfunction

Part of the book series: Current Clinical Urology ((CCU))

  • 189 Accesses

Abstract

Adenocarcinoma of the prostate is the most frequently occurring cancer in men (1). Recently, the American Urologic Association released guidelines for the management of prostate cancer. These guidelines confirmed that radical prostatectomy is the optimal treatment forlocalized prostate cancer in healthy men (2). Incontinence following prostatectomy is a condition with significant adverse effects on quality of life that all physicians caring for patients with prostate disorders will encounter. Complete knowledge of the etiology of incontinence following prostatectomy and the options of treatment will facilitate treatment of these often distressed patients.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Boring C, Squires T, Tong T (1993) Cancer Statistics. CA Cancer J Clin 43: 7–26.

    CAS  Google Scholar 

  2. Middleton R, Thompson I, Austenfeld M, et al. (1995) Prostate cancer clinical guidelines Panel summary report on the management of clinically localized prostate cancer. J Urol 154: 2144–2148.

    Article  PubMed  CAS  Google Scholar 

  3. Marks J, Light JK (1989) Management of urinary incontinence after prostatectomy with the artificial urinary sphincter. J Urol 142: 302–304.

    PubMed  CAS  Google Scholar 

  4. Mebust W, Holtgrewe H (1989) Current status of transurethral prostatectomy: a review of the AUA National Cooperative Study. World J Urol 6: 194–199.

    Google Scholar 

  5. Walsh P, Jewett A (1980) Radical Surgery for prostatic cancer. Cancer 45: 1906.

    PubMed  CAS  Google Scholar 

  6. Rudy D, Woodside J, Jeffry R, et al. (1984) Urodynamic evaluation of incontinence in patients undergoing modified Campbell radical retropubic prostatectomy: a prospective study. J Ural 132: 708–712.

    CAS  Google Scholar 

  7. Fowler F, Barry M, Lu-yao G, et al. (1995) Effect of radical prostatectomy for prostate cancer on patient quality of life: Results from a Medicare survey. Urology 45: 1007.

    Google Scholar 

  8. Herr H (1994) Quality of life of incontinent men after radical prostatectomy. J Ural 151: 652–654.

    CAS  Google Scholar 

  9. Litwin M, Hays R, Fink A, Ganz P, Leake B, Leach G, Brook R (1995) Qualityof-life outcomes in men treated for localized prostate cancer. JAMA 273: 129–135.

    Article  PubMed  CAS  Google Scholar 

  10. O’Donnell P, Finan B, Barnett T, Brookover T (1990) Continence recovery following radical prostatectomy. Neurol Urodyn 9: 251–256.

    Article  Google Scholar 

  11. Hammerer P, Huland H (1997) Urodynamic evaluation of changes in urinary control after radical retropubic prostatectomy. J Urol 157: 233–236.

    Article  PubMed  CAS  Google Scholar 

  12. Geary E, Dendinger T, Freiha F, Stamey T (1995) Incontinence and vesical neck strictures following nerve sparing radical retropubic prostatectomy. Urology 45: 1000.

    Article  PubMed  CAS  Google Scholar 

  13. McNeal JE (1968) Regional morphology and pathology of the prostate. Am J Surg Pathol 49: 347–357.

    CAS  Google Scholar 

  14. McNeal JE (1978) Origin and evolution of benign prostatic enlargement. Invest Urol 15: 340–345.

    PubMed  CAS  Google Scholar 

  15. McNeal J, Redwine E, Freiha F, Stamey T (1988) Zonal distribution of the prostatic adenocarcinoma: correlation with histologic patterns and direction of spread. Am J Surg Pathol 12: 897–906.

    Article  PubMed  CAS  Google Scholar 

  16. Turner Warwick R (1983) The sphincter mechanisms: their relationship to prostatic enlargement and its treatment. In: Hinman F Jr, ed., Benign Prostatic Hypertrophy. New York: Springer-Verlag, p. 809.

    Chapter  Google Scholar 

  17. Caine N, Raz S, Ziegler M (1975) Adrenergic and cholinergic receptors in the human prostate, prostatic capsule and bladder neck. Br J Urol 47: 193–202.

    Article  PubMed  CAS  Google Scholar 

  18. Elbadawi A (1996) Functional anatomy of the organs of micturition. Urol Clin N Am 23: 177–210.

    CAS  Google Scholar 

  19. Oelrich TM (1980) The urethral sphincter muscle in the male. Am JAnat 158: 229.

    Article  CAS  Google Scholar 

  20. Burnett A, Mostwin J (1998) In situ anatomical study of the male urethral sphincteric complex: relevance to continence preservation following major pelvic surgery. J Urol 160: 1301–1306.

    Article  PubMed  CAS  Google Scholar 

  21. Steiner MS (1994) The puboprostatic ligament and the male urethral suspensory mechanism: an anatomic study. Urology 44: 530–534.

    Article  PubMed  CAS  Google Scholar 

  22. Myers RP (1991) Male urethral sphincteric anatomy and radical prostatectomy. Urol Clin N Am 18: 211–227.

    CAS  Google Scholar 

  23. Myers R, Goellner J, Cahill D (1987) Prostate shape, external striated urethral sphincter and radical prostatectomy. J Urol 138: 543–550.

    PubMed  CAS  Google Scholar 

  24. Haab F, Yamaguchi R, Leach G (1996) Postprostatectomy incontinence. Urol Clin N Am 23: 447–457.

    Article  CAS  Google Scholar 

  25. McNeal J (1972) The prostate and prostatic urethra-a morphologic synthesis. J Urol 107: 1008–1016.

    PubMed  CAS  Google Scholar 

  26. Shah P Jr, Abrams P, Fineley R, et al. (1979) The influence of prostatic anatomy and the different results of prostatectomy according to the surgical approach. Br J Urol 51: 549–551.

    Article  PubMed  CAS  Google Scholar 

  27. Levy J, Seay T, Wein A (1996) Postprostatectomy incontinence. AUA Update Series, Lesson 8, Vol XV, 58–66.

    Google Scholar 

  28. Walsh P, Donker P (1982) Impotence following radical prostatectomy: insight into etiology and prevention. J Urol 128: 492–497.

    PubMed  CAS  Google Scholar 

  29. O’Donnell P, Finan B (1989) Continence following nerve-sparing radical prostatectomy. J Urol 142: 1227–1228.

    PubMed  Google Scholar 

  30. Steiner M, Morton R, Walsh P (1991) Impact of anatomical radical prostatectomy on urinary continence. J Urol 145: 512–515.

    PubMed  CAS  Google Scholar 

  31. Donat SM, Fair WR (1996) Radical Retropubic Prostatectomy: bladder neck preservation. AUA Update Series, Lesson 7, Vol XV, 50–57.

    Google Scholar 

  32. Malizia A, Banks D, Newton E, et al. (1989) Modified radical retropubic prostatectomy: double continence technique. J Ural 141: 316A.

    Google Scholar 

  33. Gomez C, Soloway M, Civantos F, et al. (1993) Bladder neck preservation and its impact on positive surgical margins during radical prostatectomy. Adult Urol 42: 689–694.

    CAS  Google Scholar 

  34. Licht M, Klein E, Tuason I, Levin H (1994) Impact of bladder neck preservation during radical prostatectomy on continence and cancer control. Urology 44: 883887.

    Google Scholar 

  35. Presti J Jr, Schmidt R, Narayan P, Carroll P, Tanagho E (1990) Pathophysiology of urinary incontinence after radical prostatectomy. J Urol 143: 975–978.

    PubMed  Google Scholar 

  36. Walsh P, Quinlan D, Morton R, Steiner M (1990) Radical Retropubic prostatectomy. Improved anastomosis and urinary continence. Urol Clin NAm 17: 679–684.

    CAS  Google Scholar 

  37. Klein EA (1992) Early continence after radical prostatectomy. J Urol 148: 92–94.

    PubMed  CAS  Google Scholar 

  38. Stamey TA (1991) The Stanford radical retropubic prostatectomy. J Urol 145: 49A (V-42).

    Google Scholar 

  39. Klein EA (1993) Modified apical dissection for early continence after radical prostatectomy. Prostate 22: 217–220.

    Article  PubMed  CAS  Google Scholar 

  40. Carlin B, Resnick M (1995) Anatomic approach to radical perineal prostatectomy. Urol Clin N Am 22: 461–473.

    CAS  Google Scholar 

  41. Harris M, Thompson I (1996) The anatomic radical perineal prostatectomy: a contemporary and anatomic approach. Urology 48: 762–768.

    Article  PubMed  CAS  Google Scholar 

  42. Khan Z, Mieza M, Starer P, Singh V (1991) Post-prostatectomy incontinence: a urodynamic and fluoroscopic point of view. Urology 38: 483–488.

    Article  PubMed  CAS  Google Scholar 

  43. Goluboff E, Chang D, Olsson C, Kaplan S (1995) Urodynamics and the etiology of post-prostatectomy urinary incontinence: the initial Columbia experience. J Urol 153: 1034–1037.

    Article  PubMed  CAS  Google Scholar 

  44. Chao R, Mayo M (1995) Incontinence after radical prostatectomy: Detrusor or sphincter causes. J Urol 154: 16–18.

    Article  PubMed  CAS  Google Scholar 

  45. Winters J, Appell R, Rackley R (1998) Urodynamic findings in postprostatectomy incontinence. Neurol Urodynam 17: 493–498.

    Article  CAS  Google Scholar 

  46. Fitzpatrick J, Gardiner R, Worth P (1979) The evaluation of 68 patients with postprostatectomy incontinence. Br J Urol 51: 552–555.

    Article  PubMed  CAS  Google Scholar 

  47. Yalla S, Karsh L, Kearney G, et al. (1982) Post-prostatectomy incontinence: urodynamic assessment. Neurol Urodynam 1: 77–81.

    Article  Google Scholar 

  48. Andersen JT (1976) Detrusor hyperreflexia in benign infravesical obstruction, a cystometric study. J Urol 115: 532–534.

    PubMed  CAS  Google Scholar 

  49. Foote J, Yun S, Leach G (1991) Post-prostatectomy incontinence: Pathophysiology, evaluation and management. Urol Clin N Am 18: 229–241.

    Google Scholar 

  50. Leach G, Trockman B, Wong A, et al. (1996) Post-prostatectomy incontinence: urodynamic findings and treatment outcomes. J Urol 155: 1256–1259.

    Article  PubMed  CAS  Google Scholar 

  51. Hammerer P, Huland H (1997) Urodynamic evaluation of changes in urinary control after radical retropubic prostatectomy. J Urol 157: 233–236.

    Article  PubMed  CAS  Google Scholar 

  52. Walker C, Mason D, Joseph A, Juma S (1995) Does the leak point pressure predict the severity of urinary incontinence in male patients. J Urol 153: 277A.

    Google Scholar 

  53. Appell R (1996) Personal communication.

    Google Scholar 

  54. Winters J, Appell R (1997) Practical urodynamics. In: O’Donnell P, ed., Urinary Incontinence. St. Louis, MO: Mosby-Year Book, pp. 181–189.

    Google Scholar 

  55. Moul J (1994) For incontinence after prostatectomy, tap a diversity of treatments. Contemp Urol 6: 78–88.

    CAS  Google Scholar 

  56. Sotiropoulos A, Yeaw S, Lattimer J (1976) Management of urinary incontinence with stimulation: observations and results. J Urol 116: 747–750.

    PubMed  CAS  Google Scholar 

  57. Meaglia J, Joseph A, Chang M, et al. (1990) Postprostatectomy urinary incontinence: response to behavioral training. J Urol 144: 674–676.

    PubMed  CAS  Google Scholar 

  58. Burgio K, Stutzman R, Engel B (1989) Behavioral training for postprostatectomy urinary incontinence. J Urol 141: 303–306.

    PubMed  CAS  Google Scholar 

  59. Worth P (1984) Postprostatectomy incontinence. In: Mundy A, Stephenson T, Wein A, eds., Urodynamics. New York, NY: Churchill Livingstone, pp. 205–211.

    Google Scholar 

  60. Politano V (1992) Transurethral Polytef for post-prostatectomy urinary incontinence. Br J Urol 69: 26–28.

    Article  PubMed  CAS  Google Scholar 

  61. Malizia A, Reiman H, Myers R, et al. (1984) Migration and granulomatous reaction after periurethral injection of polytef (teflon). JAMA 251: 3277–3281.

    Article  PubMed  Google Scholar 

  62. Remade M, Marbaix E (1988) Collagen implants in the human larynx: pathologic dissemination of two cases. Arch Otolaryngol 245: 203–209.

    Google Scholar 

  63. Shortliffe L, Freiha F, Kessler R, Stamey T, Constantinou C (1989) Treatment of urinary incontinence by the periurethral implantation of glutaraldehyde cross-linked collagen. J Urol 141: 538–541.

    PubMed  CAS  Google Scholar 

  64. Appell R, McGuire E, DeRidder P, Bennett A, Webster G, Badlani G, et al. (1994) Summary of effectiveness in the prospective, open, multicenter investigation of Contigen implant for incontinence due to intrinsic sphincteric deficiency in males. J Urol, part 2, 151: 217A (abstract 174).

    Google Scholar 

  65. Aboseif S, O’Connell H, Usui A, McGuire E (1996) Collagen injection for intrinsic sphincteric deficiency in men. J Urol 155: 10–13.

    Article  PubMed  CAS  Google Scholar 

  66. Herschorn S, Radomski S, Steele D (1992) Early experience with intraurethral collagen injections for urinary incontinence. J Urol 148: 1797–1800.

    PubMed  CAS  Google Scholar 

  67. Cummings J, Boullier J, Pana R (1996) Transurethral collagen injections in the therapy of post-radical prostatectomy stress incontinence. J Urol 155: 1011–1013.

    Article  PubMed  CAS  Google Scholar 

  68. Kageyama S, Kawabe K, Suzuki K, Ushiyama T, Suzuki T, Aso Y (1994) Collagen Implantation for post-prostatectomy incontinence: early experience with a transrectal ultrasonographically guided method. J Urol 152: 1473–1475.

    PubMed  CAS  Google Scholar 

  69. Griebling T, Kreder K, Williams R (1997) Transurethral collagen injection for treatment of postprostatectomy urinary incontinence in men. Urology 49: 907–912.

    Article  PubMed  CAS  Google Scholar 

  70. Smith D, Appell R, Rackley R, Winters J (1998) Collagen injection therapy in postprostatectomy incontinence. J Urol 160: 364–367.

    Article  PubMed  CAS  Google Scholar 

  71. Appell R, Vasavada S, Rackley R, Winters J (1996) Percutaneous antegrade collagen injection therapy for urinary incontinence following radical prostatectomy. Urology 48: 769–772.

    Article  PubMed  CAS  Google Scholar 

  72. Klutke C, Nadler R, Andriole G (1995) Antegrade collagen injection: New technique for postprostatectomy stress incontinence (Surgeon’s Workshop) J Endourol 9: 513–515.

    Article  PubMed  CAS  Google Scholar 

  73. Klutke C, Nadler R, Tiemann D, Andriole G (1996) Early results with antegrade collagen injection for post-radical prostatectomy stress urinary incontinence. J Urol 156: 1703–1706.

    Article  PubMed  CAS  Google Scholar 

  74. Vasavada S, Appell R, Rackley R, Winters J (1997) Long term follow-up in men treated with antegrade collagen for post-prostatectomy incontinence. J Urol I57: 394A.

    Google Scholar 

  75. Litwiller S, Kim K, Fone P, White R, Stone A (1996) Post-prostatectomy incontinence and the artificial urinary sphincter: a long term study of patient satisfaction and criteria for success. J Urol 156: 1975–1980.

    Article  PubMed  CAS  Google Scholar 

  76. Montague DK (1992) The artificial urinary sphincter (AS 800): experience in 166 consecutive cases. J Urol 147: 380–382.

    PubMed  CAS  Google Scholar 

  77. Haab F, Trockman B, Zimem P, Leach G (1997) Quality of life and continence assessment of the artificial urinary sphincter in men with minimum 3.5 years follow-up. J Urol 158: 435–439.

    Article  PubMed  CAS  Google Scholar 

  78. Elliot D, Barrett D (1998) Mayo Clinic long-term analysis of the functional durability of the AMS 800 artificial urinary sphincter: a review of 323 cases. J Urol 159: 1206–1208.

    Article  Google Scholar 

  79. Light JK (1990) Complications of surgery for male urinary incontinence including the artificial urinary sphincter. In: Marshall F, ed., Urologic Complications, 2nd ed. St. Louis, MO: Mosby Year Book, pp. 328–337.

    Google Scholar 

  80. Couillard D, Vapnek J, Stone A (1995) Proximal artificial sphincter cuff repositioning for urethral atrophy incontinence. Urology 45: 653–656.

    Article  PubMed  CAS  Google Scholar 

  81. Brito, Mulcahy J, Mitchell M, Adams M (1993) Use of a double cuff AMS 800 urinary sphincter for severe stress incontinence. J Urol 149: 283–285.

    PubMed  CAS  Google Scholar 

  82. Goldwasser B (1990) Avoiding the problems of artificial urinary sphincter implantation. Probl Urol 4: 187–199.

    Google Scholar 

  83. Mark S, Perez L, Webster G (1994) Synchronous management of anastomotic contracture and stress urinary incontinence following radical prostatectomy. J Urol 151: 1202–1204.

    PubMed  CAS  Google Scholar 

  84. Martins F, Boyd S (1995) Artificial urinary sphincter in patients following major pelvic surgery and/or radiotherapy: are they less favorable candidates? J Urol 153: 1188–1193.

    Article  PubMed  CAS  Google Scholar 

  85. Wang Y, Hadley R (1992) Experiences with the artificial urinary sphincter in the irradiated patient. J Urol 147: 612–613.

    PubMed  CAS  Google Scholar 

  86. Raz S, McGuire E, Erlich R (1988) Fasciai sling to correct male neurogenic sphincter incompetence: the McGuire/Raz procedure approach. J Urol 139: 528531.

    Google Scholar 

  87. Schaeffer A, Clemens J, Ferrari M, Stamey T (1988) The male bulbourethral sling procedure for post-radical prostatectomy incontinence. J Urol 159: 1510–1515.

    Article  Google Scholar 

  88. Gonzalez R, Nguyen D, Koleilat N, Sidi A (1989) Compatibility of enterocystoplasty and the artificial urinary sphincter. J Urol 144 (2 pt 2): 502–504.

    Google Scholar 

  89. Perez L, Webster G (1992) Successful outcome of artificial urinary sphincters in men with post-prostatectomy incontinence despite adverse implantation features. J Urol 148: 1166–1170.

    PubMed  CAS  Google Scholar 

  90. Stothers L, Chopra A, Raz S (1995) A cost-effectiveness and utility analysis of the artificial urinary sphincter and collagen injections in the treatment of postprostatectomy incontinence. J Urol 153: 278A.

    Google Scholar 

  91. Brown J, Elliot D, Barrett D (1998) Postprostatectomy urinary incontinence: A comparison of the cost of conservative versus surgical management. Urology 51: 715–720.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. Harriette M. Scarpero MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Christian Winters MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Section of Voiding Dysfunction and Female Urology, Department of Urology, Cleveland Clinic Foundation, Cleveland, OH, USA

    Rodney A. Appell MD

Rights and permissions

Reprints and permissions

Copyright information

© 2000 Humana Press Inc., Totowa, NJ

About this chapter

Cite this chapter

Scarpero, H.M., Winters, J.C. (2000). Post-Prostatectomy Incontinence. In: Appell, R.A. (eds) Voiding Dysfunction. Current Clinical Urology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-198-5_11

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-198-5_11

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-4684-9689-5

  • Online ISBN: 978-1-59259-198-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation