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Title: Impact of bladder dysfunction in the management of post radical prostatectomy stress urinary incontinence-a review.
Austin Authors: Hennessey, Derek B;Hoag, Nathan;Gani, Johan 
Affiliation: Department of Urology, Austin Health, Heidelberg, Victoria, Australia
Department of Urology, Victoria General Hospital, Victoria, British Columbia, Canada
Department of Urology, Western Health, Footscray, Victoria, Australia
Issue Date: Jul-2017
Publication information: Translational andrology and urology 2017; 6(Suppl 2): S103-S111
Abstract: Bladder dysfunction is a relatively common urodynamic finding post radical prostatectomy (RP). It can be the sole cause of post prostatectomy incontinence (PPI) or may be found in association with stress urinary incontinence (SUI). The aim of this review is to provide a comprehensive review of the diagnosis and different treatments of post RP bladder dysfunction. A comprehensive literature review using medical search engines was performed. The search included a combination of the following terms, PPI, detrusor overactivity (DO), detrusor underactivity (DU), impaired compliance, anticholinergic, onabotulinumtoxinA (Botox®) and sacral neuromodulation (SNM). Definitions, general overview and management options were extracted from the relevant medical literature. DO, DU and impaired compliance are common and may occur alone or in combination with SUI. In some patients the conditions exist pre RP, in others they arise due to denervation and surgical changes. DO can be treated with anticholinergics, Botox® and SNM. DO may need to be treated before SUI surgery. DU may be a contraindication to male sling surgery as some patients may go into urinary retention. Severely impaired bladder compliance may be a contraindication to SUI surgery as the upper tracts may be at risk. Each individual dysfunction may affect the outcome of PPI treatments and clinicians should be alert to managing bladder dysfunction in PPI patients.
DOI: 10.21037/tau.2017.04.14
ORCID: 0000-0002-7372-0100
Journal: Translational andrology and urology
PubMed URL: 28791229
ISSN: 2223-4691
Type: Journal Article
Subjects: Post prostatectomy incontinence (PPI)
detrusor overactivity (DO)
detrusor underactivity (DU)
impaired compliance
sacral neuromodulation (SNM)
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