RT Journal Article
SR Electronic
T1 Literature review of factors affecting continence after radical prostatectomy
JF Saudi Medical Journal
JO Saudi Med J
FD Prince Sultan Military Medical City
SP 9
OP 17
DO 10.15537/smj.2017.1.15293
VO 38
IS 1
A1 Dalibor Pacik
A1 Michal Fedorko
YR 2017
UL http://smj.org.sa/content/38/1/9.abstract
AB Radical prostatectomy (RP) is the most common cause of stress urinary incontinence (UI) in men. Several anatomic structures affect or may affect urinary continence - urethral sphincter, levator ani muscle, puboprostatic ligaments, bladder neck, endopelvic fascia, neurovascular bundle - and understanding of the anatomy of pelvic floor and urethra is crucial for satisfactory functional outcome of the procedure. Surgical techniques implemented to improve continence rates include nerve-sparing procedure, bladder neck preservation/plication, urethral length preservation, musculofascial reconstruction, puboprostatic ligaments preservation or seminal vesicle preservation. Perioperative (preoperative and postoperative) pelvic floor muscle training (PFMT) aims to shorten the duration of postoperative UI and thus, improve early continence rates postoperatively. In the review, complex information regarding anatomical, intra- and perioperative factors affecting urinary continence after RP is provided, including description of important anatomical structures, possible implications for surgical technique and evaluation of different PFMT strategies in perioperative period.