Urethral sphincter function before and after radical prostatectomy: Systematic review of the prognostic value of various assessment techniques
- PMID: 23371847
- DOI: 10.1002/nau.22355
Urethral sphincter function before and after radical prostatectomy: Systematic review of the prognostic value of various assessment techniques
Abstract
Aims: Urethral sphincter incompetence is generally considered to be the most important contributing factor to post-radical prostatectomy incontinence (PRPI). The value of various assessment techniques used to objectify urethral sphincter function before and/or after RP is unclear. Our review addresses the following questions: In men having to undergo RP, which measurement techniques that assess pre-operative and post-operative urethral sphincter function have predictive value for the post-operative continence status or correlate with the post-operative continence status.
Methods: A systematic and comprehensive search was performed using the terms: urethral sphincter, radical prostatectomy (RP), and urinary incontinence. Results were restricted to English-language papers published between 1980 and March 2012. Only techniques described by at least two studies were included.
Results: Several assessment techniques for urethral sphincter function and anatomy were identified: sphincter electromyography, magnetic resonance imaging (MRI), perfusion sphincterometry and urethral pressure profilometry (UPP). A shorter urethral sphincter length on preoperative endorectal MRI might be associated with an increased risk of PRPI as well as longer time to achieve continence. UPP showed that both maximum urethral closure pressure (MUCP) and functional profile length (FPL) decrease significantly after RRP. Low preoperative MUCP and FPL are associated with an increased risk of PRPI. The other mentioned assessment techniques are not usable as preoperative diagnostic tools.
Conclusions: MRI and UPP might be valuable preoperative diagnostic tools in patients waiting for RRP. However, more and larger studies are needed to show the exact role of MRI and UPP in the preoperative management of patients waiting for RRP and for whom post-operative incontinence is a big concern.
Keywords: radical prostatectomy; urethral sphincter function.
Copyright © 2013 Wiley Periodicals, Inc.
Comment in
-
Re: urethral sphincter function before and after radical prostatectomy: systematic review of the prognostic value of various assessment techniques.J Urol. 2014 May;191(5):1341-2. doi: 10.1016/j.juro.2014.02.034. Epub 2014 Feb 20. J Urol. 2014. PMID: 24745505 No abstract available.
Similar articles
-
Urethral pressure profile before radical prostatectomy as a predictor of early postoperative continence.Neurourol Urodyn. 2022 Aug;41(6):1431-1439. doi: 10.1002/nau.24978. Epub 2022 Jun 7. Neurourol Urodyn. 2022. PMID: 35670263
-
Pathophysiology and Contributing Factors in Postprostatectomy Incontinence: A Review.Eur Urol. 2017 Jun;71(6):936-944. doi: 10.1016/j.eururo.2016.09.031. Epub 2016 Oct 6. Eur Urol. 2017. PMID: 27720536 Review.
-
Systematic review and meta-analysis of studies reporting urinary continence recovery after robot-assisted radical prostatectomy.Eur Urol. 2012 Sep;62(3):405-17. doi: 10.1016/j.eururo.2012.05.045. Epub 2012 Jun 1. Eur Urol. 2012. PMID: 22749852 Review.
-
Urodynamic quantification of decrease in sphincter function after radical prostatectomy: relation to postoperative continence status and the effect of intensive pelvic floor muscle exercises.Neurourol Urodyn. 2012 Jun;31(5):646-51. doi: 10.1002/nau.21243. Epub 2012 Apr 6. Neurourol Urodyn. 2012. PMID: 22488800 Clinical Trial.
-
Urethral pressure profile 6 months after radical prostatectomy may be diagnostic of sphincteric incontinence: preliminary data after 12 months' follow-up.Scand J Urol Nephrol. 2009;43(2):114-8. doi: 10.1080/00365590802603018. Scand J Urol Nephrol. 2009. PMID: 19085324
Cited by
-
Precise Prediction of Long-Term Urinary Incontinence after Robot-Assisted Laparoscopic Radical Prostatectomy by Readily Accessible "Everyday" Diagnostics during Post-Surgical Hospitalization.Clin Pract. 2024 Apr 23;14(3):661-671. doi: 10.3390/clinpract14030053. Clin Pract. 2024. PMID: 38804385 Free PMC article.
-
Prospective evaluation of an intraoperative urodynamic stress test predicting urinary incontinence after robot-assisted laparoscopic radical prostatectomy.Urol Ann. 2023 Apr-Jun;15(2):166-173. doi: 10.4103/ua.ua_47_22. Epub 2023 Jan 16. Urol Ann. 2023. PMID: 37304501 Free PMC article.
-
Pre-prostatectomy membranous urethral length as a predictive factor of post prostatectomy incontinence requiring surgical intervention with an artificial urinary sphincter or a male sling.Neurourol Urodyn. 2022 Apr;41(4):973-979. doi: 10.1002/nau.24904. Epub 2022 Mar 9. Neurourol Urodyn. 2022. PMID: 35266177 Free PMC article.
-
Prediction of Postradical Prostatectomy Urinary Incontinence Through the Combination of the Urethral Pressure Profile With Electromyography of the Urethral Sphincter.Int Neurourol J. 2022 Feb;26(Suppl 1):S68-75. doi: 10.5213/inj.2142030.015. Epub 2022 Feb 28. Int Neurourol J. 2022. PMID: 35236049 Free PMC article.
-
Preoperative Prostate MRI Predictors of Urinary Continence Following Radical Prostatectomy.Radiology. 2022 Apr;303(1):99-109. doi: 10.1148/radiol.210500. Epub 2022 Jan 18. Radiology. 2022. PMID: 35040671 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical