pelviperineology. 2022; 41(1): 54-62 | DOI: 10.34057/PPj.2022.41.01.2021-8-7

Post-prostatectomy incontinence in patients with adjuvant radiotherapy: is there a therapeutic space for transobturator sling?

Salvatore SIRACUSANO¹, Carolina D’ELIA², Federico ROMANTINI¹, Daniela FASANELLA^1
1Department of Urology of Teramo, University of L’Aquila, Teramo, Italy, ²Department of Urology of Bolzano, General Hospital, Bolzano, Italy

Objectives: Stress urinary incontinence (SUI) is a common sequela in patients undergoing surgery for prostate cancer, ranging from 4% to 31% in patients treated with robot assisted radical prostatectomy (RARP), and from 7% to 40% in patients undergoing radical retropubic prostatectomy (RP). At this moment, only poor-quality studies evaluated the surgical techniques proposed for these patients; moreover, a limited number of studies evaluated both adjustable and non-adjustable slings, but no randomized trials are available. Nevertheless, it’s important to highlight, that patients at high risk of local recurrence after RP will undergo adjuvant radiotherapy (RT), increasing the risk of postoperative complications and failure, if surgically treated for SUI. In this context few studies analyzed the outcome of post-prostatectomy sling positioning in patients treated with radiotherapy. The aim of this narrative review is to summarize current data regarding outcomes after sling placement in patients with history of radiotherapy. Materials and Methods: Outcome definition and measures, design of the studies, follow-up, numerosity and the type of sling used (Argus, AdVance/XP, Invance) are still heterogeneous. Due to different follow-up and the low number of patients it is difficult to compare data. Results: The larger study was a prospective multicenter paper, evaluating the outcomes of the Argus-T Sling, and documenting a 61.2% success rate in patients undergoing radiotherapy, with a higher risk of sling removal and urethral erosion. Conclusion: At present, due to the lack of large prospective studies it is impossible to draw definite conclusions.

---

Cite This Article

SIRACUSANO S, D’ELIA C, ROMANTINI F, FASANELLA D. Post-prostatectomy incontinence in patients with adjuvant radiotherapy: is there a therapeutic space for transobturator sling?. 2022; 41(1): 54-62

Corresponding Author: SIRACUSANO S.

 | Full Text PDF