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Year : 2014  |  Volume : 30  |  Issue : 3  |  Page : 362

Post Prostatectomy Incontinence-A Clinical Guide

Honorary Professor, Apollo Hospital Education and Research Foundation, Consultant Urologist and Transplant Surgeon, Apollo Hospital, Hyderguda and Jubilee Hills, Hyderabad, India

Date of Web Publication1-Jul-2014

Correspondence Address:
Sanjay Sinha
Honorary Professor, Apollo Hospital Education and Research Foundation, Consultant Urologist and Transplant Surgeon, Apollo Hospital, Hyderguda and Jubilee Hills, Hyderabad
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Source of Support: None, Conflict of Interest: None

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How to cite this article:
Sinha S. Post Prostatectomy Incontinence-A Clinical Guide. Indian J Urol 2014;30:362

How to cite this URL:
Sinha S. Post Prostatectomy Incontinence-A Clinical Guide. Indian J Urol [serial online] 2014 [cited 2021 Oct 28];30:362. Available from:

Edited by Ajay Singla

Lap Lambert Academic Publishing, Saarbrucken, Germany

A combination of widespread prostate-specific antigen (PSA) testing and the increasing adoption of robotic technology are fuelling a boom in radical prostatectomy across the world. It has been estimated that each additional robot in a given geographical area has the potential to increase the number of radical prostatectomies by 30%. [1] Clearly, with rapid adoption of robotic technology, India is sitting at the cusp of an explosion in radical prostate surgery. With 6-9% of patients undergoing radical prostatectomy opting for some form for surgical treatment for post-prostatectomy incontinence, such patients are soon going to become common place in urological practice. [2] Dr Ajay Singla's book "Post Prostatectomy Incontinence A Clinical Guide (Lap Lambert Academic Publishing, 2013)" targets this contemporary but somewhat bemused urologist who eyes the plethora of surgical options with trepidation.

Dr Singla's book has several strengths. Various forms of non-surgical and surgical therapies are discussed in detail in nine chapters spanning 192 pages. Specifically, a variety of male sling devices are discussed by different surgeons, each with personal experience in the use of the concerned device. Details of techniques and outcome are presented. Several tables have been compiled to present the data concerning each device. Being pioneers, the authors have given a practical perspective on each of the techniques. The book ends with a chapter on the artificial urinary sphincter.

However, the book leaves one with the impression of being a compilation of techniques rather than a comprehensive treatise on a complex subject. Six chapters deal with different male slings while artificial sphincter, the established standard of care with the most robust data, finds only a single chapter. A detailed discussion regarding the anatomical basis of continence is lacking. While each author presents data from small case series, there is lack of a dispassionate assessment of the overall quality of evidence regarding slings as compared to the artificial sphincter. [3] There is only one treatment algorithm in the book and despite description of various techniques, the reader may remain uncertain regarding the best approach for a given patient.

The number of patients with radical prostatectomies is clearly set to increase. Fortunately, evidence also shows a consolidation of such surgeries at high-volume centers with possible favorable implications. [4] Although incontinence rates might be stabilizing, incontinence remains an important post-operative complication. On the urological bookshelf, there is clearly room for an authoritative book on post-prostatectomy incontinence. Dr Singla's textbook is recommended for all urologists involved in the clinical care of patients with incontinence following prostatectomy.

   References Top

1.Barbash GI, Friedman B, Glied SA, Steiner CA. Factors associated with adoption of robotic surgical technology in US hospitals and relationship to radical prostatectomy procedure volume. Ann Surg 2014;259:1-6.  Back to cited text no. 1
2.Herschorn S, Bruschini H, Comiter C, Grise P, Hanus T, Kirschner-Hermanns R, Abrams P . Surgical treatment of stress incontinence in men. In: Abrams P, Cardozo L, Khoury S, Wein A, editors. Incontinence-4 th International Consultation. Paris: Health Publications; 2009. p. 1121-90.  Back to cited text no. 2
3.Bauer RM, Bastian PJ, Gozzi C, Stief CG. Postprostatectomy incontinence: All about diagnosis and management. Eur Urol 2009;55:322-33.  Back to cited text no. 3
4.Anderson CB, Penson DF, Ni S, Makarov DV, Barocas DA. Centralization of radical prostatectomy in the United States. J Urol 2013;189:500-6.  Back to cited text no. 4


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