Recovery of urinary continence after radical prostatectomy

In the era of minimally-invasive surgery, urinary incontinence (UI) after radical prostatectomy (RP) still represents a troublesome issue for a considerable rate of patients. Factors associated with the risk of post-RP UI, need to be carefully assessed throughout the overall clinical management process thus including the pre-operative, intra-operative and post-operative setting.

This review analyses current published evidences regarding clinical and surgical aspects associated with urinary continence (UC) recovery after RP. A careful evaluation of patient's clinical characteristics should be carried out before surgery in order to properly counsel the patients regarding the risk of UI. In the last two decades, the advent of robotic surgery has led to an overall improvement of functional outcomes after RP, thanks to the development of different surgical strategies based on either the "preservation" or the "reconstruction" of the anatomical elements responsible for urinary continence. Finally, several therapeutic strategies including either a conservative approach, or pharmacological and surgical treatments, should be carefully considered for the post-operative management of UI. Expert Commentary: A comprehensive pre-operative patient's clinical assessment, along with a proper and well-conducted surgical procedure and an effective post-operative care management are essential element to achieve a high probability of UC recovery.

Expert review of anticancer therapy. 2016 Sep 16 [Epub ahead of print]

Paolo Capogrosso, Rafael Sanchez-Salas, Andrea Salonia, Nathalie Cathala, Annick Mombet, Arjun Sivaraman, Eric Barret, Francesco Montorsi, Xavier Cathelineau

a Università Vita-Salute San Raffaele , Milan , Italy., c Department of Urology ; L'Institut Mutualiste Montsouris , Paris , France.