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Review Article

Do Drugs Work for ΟΑΒ Following Prostate Cancer Surgery

Author(s): Vasileios Sakalis * and Anastasia Gkotsi

Volume 21, Issue 15, 2020

Page: [1515 - 1526] Pages: 12

DOI: 10.2174/1389450121666200716202103

Price: $65

Abstract

There is evidence that post-radical prostatectomy (post-RP) incontinence is not just the insufficiency of the external urethral sphincter mechanism. Up to a third of men with post-RP incontinence suffer from bladder dysfunction, namely overactive bladder (OAB). OAB is a complex symptom syndrome with poorly defined pathophysiology. It causes a significant burden to patients, negatively affects the quality of their life and its management might be difficult and challenging.

The incidence of post-RP OAB ranges from 15.2 to 37.8%. The aetiology is multifactorial and includes the partial decentralization of the bladder, the detrusor underactivity, the bladder outlet obstruction and the co-existence with stress urinary incontinence (SUI). Post-RP SUI may lead to defunctionalized bladder and activation of urethrovesical reflex which further deteriorate post-RP continence. The diagnostic work-up of men with post-RP OAB should aim to identify potential aetiologic factors and personalize the treatment accordingly.

Until now, there is no robust data from literature with regards to post-RP OAB management. It seems that anticholinergics and PDE5 inhibitors are effective in improving OAB parameters.

Keywords: Overactive bladder, urge incontinence, radical prostatectomy, prostate cancer, urgency, mixed incontinence.

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