A SYSTEMATIC REVIEW OF ANALYZING THE EFFECTIVENESS OF SURGICAL INTERVENTIONS FOR PROSTATECTOMY-RELATED URINARY INCONTINENCE

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Akashnath Kivalur Ganeshanath
Sarwat Ali Raja
Razia Virk
Laraib Ali
Adnan Manzoor
Rana Anees Ur Rehman
Muhammad Omer Khan
Charles J Cheng
Afzaal Ajmal
Ashtar Kariem

Keywords

Prostatectomy, urinary incontinence, Artificial Urinary Sphincter, male slings, urethral bulking agents, Adjustable Continence Therapy, surgical interventions

Abstract

Background: Prostatectomy-related urinary incontinence (UI) is a common and debilitating complication following radical prostatectomy, significantly impacting patient quality of life.


Methodology: This systematic review aims to assess the effectiveness of various surgical interventions for managing prostatectomy-related UI, including Artificial Urinary Sphincter (AUS), male slings, urethral bulking agents, and Adjustable Continence Therapy (ACT). Nine genuine studies from 2014 to 2024 were selected based on their high-quality evidence, examining the outcomes, safety profiles, and patient satisfaction associated with these surgical options.


Results: The review found that AUS provides the highest rates of continence recovery but carries higher risks of complications such as mechanical failure and infection. Male slings, particularly robotic-assisted techniques, demonstrated good continence outcomes with fewer complications, offering a viable alternative for patients unfit for more invasive surgery. Urethral bulking agents and ACT, though less effective, are still considered in cases where other surgeries are unsuitable. The variability in study design and follow-up times underlines the need for further research to refine treatment selection and standardize outcome measures.


Conclusion: This review concludes that while AUS remains the gold standard for treating post-prostatectomy UI, male slings and newer, less invasive techniques offer promising alternatives. Further studies are needed to explore long-term outcomes, patient-reported experiences, and the cost-effectiveness of each intervention, contributing to a more tailored and effective treatment approach.

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