Do drugs work for ΟΑΒ following prostate cancer surgery?

There is evidence that post-radical prostatectomy (post-RP) incontinence is not just insufficiency of external urethral sphincter mechanism. Up to a third of men with post-RP incontinence, suffer from bladder dysfunction, namely overactive bladder (OAB). OAB is complex symptom syndrome with poorly defined pathophysiology. It causes significant burden to patients, negatively affects quality of life and its management might be difficult and challenging. The incidence of post-RP OAB ranges from 15.2 to 37.8%. The aetiology is multifactorial and includes the iatrogenic decentralization of the bladder, the detrusor underactivity, the bladder outlet obstruction and the co-existence with SUI. PostRP SUI may lead to defunctionalized bladder and to activation of urethrovesical reflex which further deteriorate post-RP continence. The diagnostic work of men with post-RP OAB should aim to identify potential aetiologic factors and personalize the treatment accordingly. Up to date there is no robust data from literature with regards to post-RP OAB management. It seems that anticholinergics and PDE5 inhibitors are effective in improving OAB parameters.

Current drug targets. 2020 Jul 16 [Epub ahead of print]

Vasileios Sakalis, Anastasia Gkotsi

Agios Pavlos, General Hospital of Thessaloniki, Urology. Greece.