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The journal «ONCOSURGERY» 2014, Vol.6, No 1

Possibilities for surgical treatment of patients with urinary incontinence after radical prostatectomy

Veliev EI, Golubtsova EN, Tomilov AA

Russian Medical Academy of Post-graduate Education, department of urology and andrology, Moscow, Russia
Contact: Tomilov Andrey Aleksandrovich, e-mail:

The objective. To study efficiency and safety for insertion of artificial urinary sphincter and implantation of transobturatory retrobulbar sling in treatment urinary incontinence after radical prostatectomy.

Material and methods. The study included 34 men with urinary incontinence after radical prostatectomy. The grades of incontinence were defined as follows: use of 1-2 pads – mild, 3-5 pads – moderate, use of 6 and more pads – severe urinary incontinence. According to treatment method all patients were divided into 2 groups. The group 1 included 21 patients underwent insertion of artificial urinary sphincter. The group 2 included 13 patients recieved implantation of transobturatory retrobulbar sling. No need for pad or use of no more than 1 protective pad per day was defined as recovery, use of up to 2 pads or reduction of urinary loss by more than 50% was defined as improvement.

Results. The median follow-up accounted for 46 months (interquartile range from 20 to 58 months) in the group 1 and 26 months (interquartile range from 21 to 40 months). The rates of recovery, improvement and failure in group 1 were 89.5%, 5.3% and 5.3% respectively. For the group 2 recovery, improvement and failure were in 11/13, 1/13 and 1/13 patients respectively. There were no complications more than I grade by Dindo in the group 2. For the group 1 complications of II and IIIa grade were diagnosed in 1 and 2 patients respectively.

Conclusion. Both insertion of artificial urinary sphincter and implantation of transobturatory retrobulbar sling are efficient and safe methods for surgical correction of stress urinary incontinence after radical prostatectomy. For patients with severe urinary incontinence insertion of artificial urinary sphincter remains a «gold standard» of treatment. Patients with mild and moderate urinary incontinence should be considered for implantation of transobturatory retrobulbar sling.

KEY WORDS: urinary incontinence, radical prostatectomy, artificial urinary sphincter, male sling.


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