title: Pharmacological Treatment of Post-Prostatectomy Incontinence: What is the Evidence?
abstract: Urinary incontinence is a common and debilitating problem, and post-prostatectomy incontinence (PPI) is becoming an increasing problem, with a higher risk among elderly men. Current treatment options for PPI include pelvic floor muscle exercises and surgery. Conservative treatment has disputable effects, and surgical treatment is expensive, is not always effective, and may have complications. This article describes the prevalence and causes of PPI and the current treatment methods. We conducted a search of the PUBMED database and reviewed the current literature on novel medical treatments of PPI, with special focus on the aging man. Antimuscarinic drugs, phosphodiesterase inhibitors, duloxetine, and α-adrenergic drugs have been proposed as medical treatments for PPI. Most studies were small and used different criteria for quantifying incontinence and assessing treatment results. Thus, there is not enough evidence to recommend the use of these medications as standard treatment of PPI. To determine whether medical therapy is a viable option in the treatment of PPI, randomized, placebo-controlled studies are needed that also assess side effects in the elderly population.
authors.affiliation: Department of Urology, Akershus University Hospital, Lørenskog, Norway.
authors.forename: Anja
authors.initials: A
authors.lastname: Løvvik
authors.affiliation: Department of Urology, Akershus University Hospital, Lørenskog, Norway.|Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors.forename: Stig
authors.initials: S
authors.lastname: Müller
authors.affiliation: Department of Urology, University Hospital North Norway, PO Box.102, N-9038, Tromsø, Norway. urology@hrpatel.org.
authors.forename: Hitendra R H
authors.initials: HR
authors.lastname: Patel
mesh_terms: D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000368:Aged; D000375:Aging; D000818:Animals; D000072700:Conservative Treatment / Q000379:methods; D000068736:Duloxetine Hydrochloride / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D005081:Exercise Therapy; D006801:Humans; D008297:Male; D018727:Muscarinic Antagonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D010726:Phosphodiesterase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D011468:Prostatectomy / Q000009:adverse effects*; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery
chemical_list: D000316:Adrenergic alpha-Agonists; D018727:Muscarinic Antagonists; D010726:Phosphodiesterase Inhibitors; D000068736:Duloxetine Hydrochloride