UI is a common adverse effect of localized prostate cancer treatment, potentially leading to a significantly diminished quality of life. Studies with patient questionnaires demonstrated that men undergoing radical prostatectomy had more leakage due to sphincter deficiency than those undergoing radiation. Radiated patients experienced more frequency and urgency in the acute inflammatory period. With the support of medical treatment and physiotherapy, UI tends to diminish during the first year. Surgery is indicated for the few patients reporting severe incontinence. Accurate patient information and explanation of treatment options with their potential risks and benefits can help the patient make an informed rational decision regarding treatment of prostate cancer. Good patient communication can also help to improve the quality of life in the early posttreatment period.
Algorithm of management for urinary incontinence (UI) following treatment for localized prostate cancer.
Philippe Grise, MD, and Scott Thurman, MD