The treatment of stress incontinence in men: part 2 of a series of articles on incontinence.
BACKGROUND
Stress incontinence in men is a rare, usually iatrogenic condition. Its prevalence can be expected to rise in the future because of the increasingly common performance of radical prostatectomy. Most men who have undergone prostatectomy experience a transient disturbance of urinary continence. Such disturbances are only rarely due to structural damage to the sphincter apparatus and therefore have a good prognosis for spontaneous recovery.


METHODS
Selective literature review.


RESULTS
Pelvic floor training and/or pharmacotherapy can be used for more rapid restoration of subjectively satisfactory urinary continence. If the sphincter is intact, continence can also be regained in the early postoperative period through the submucosal injection of bulking agents. Incontinent patients whose urinary sphincter is dysfunctional because of denervation or direct injury to striated muscle can now be treated with a variety of surgical techniques. The implantation of an artificial sphincter is the gold standard of therapy. Properly selected and informed patients can also be treated with minimally invasive procedures, such as the creation of a male suburethral sling, although the experience with such procedures to date has not been extensive.


CONCLUSIONS
Post-prostatectomy incontinence has a good prognosis and should thus be treated conservatively at first. If it nonetheless persists, surgical treatment is indicated for patients who choose it after being fully informed about their options.
Börgermann
Christof
C
Klinik für Urologie, Kinderurologie und Uroonkologie, Krankenhaus Düren gGmbH, Roonstr. 30 52351 Düren, Germany. christof.boergermann@krankenhaus-dueren.de
Kaufmann
Albert
A
Sperling
Herbert
H
Stöhrer
Manfred
M
Rübben
Herbert
H
D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use; D001521:Behavior Therapy / Q000379:methods*; D000068736:Duloxetine Hydrochloride; D004599:Electric Stimulation Therapy / Q000379:methods*; D006801:Humans; D008297:Male; D011468:Prostatectomy / Q000009:adverse effects*; D013876:Thiophenes / Q000627:therapeutic use*; D014550:Urinary Incontinence, Stress / Q000175:diagnosis* / Q000209:etiology*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*
D018759:Adrenergic Uptake Inhibitors; D013876:Thiophenes; D000068736:Duloxetine Hydrochloride