Radadia Kushan D, Farber Nicholas J, Shinder Brian, Polotti Charles F, Milas Lee J, Tunuguntla Hari S G R
Division of Urology, Department of Surgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ.
Division of Urology, Department of Surgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ.
Urology. 2018 Mar;113:13-19. doi: 10.1016/j.urology.2017.09.025. Epub 2017 Oct 12.
Postprostatectomy urinary incontinence has a significant impact on the quality of life of patients who undergo radical prostatectomy. Stress and overflow incontinence may result from the procedure, with sphincteric incompetence and detrusor hypocontractility implicating their development, respectively. In many cases, treatment begins with conservative approaches, including pelvic floor muscle training or biofeedback. Pharmacotherapy can be used to treat overactive bladder. For stress incontinence, transurethral bulking agents are utilized in select patients; however, artificial urinary sphincter and male slings are the most efficacious options with good success rates. In this review, the various treatment modalities are critically discussed with special emphasis on safety and efficacy.
前列腺切除术后尿失禁对接受根治性前列腺切除术的患者的生活质量有重大影响。手术可能导致压力性和充溢性尿失禁,分别与括约肌功能不全和逼尿肌收缩力减弱有关。在许多情况下,治疗从保守方法开始,包括盆底肌训练或生物反馈。药物治疗可用于治疗膀胱过度活动症。对于压力性尿失禁,在特定患者中使用经尿道填充剂;然而,人工尿道括约肌和男性吊带是最有效的选择,成功率很高。在这篇综述中,对各种治疗方式进行了批判性讨论,特别强调了安全性和有效性。