Editing Functional: Surgery for Male SUI (section)

=== Other ===

* '''<span style="color:#ff0000">Cystoscopy</span>'''
** '''<span style="color:#ff0000">Should be performed to assess for urethral and bladder pathology that may affect outcomes of surgery[https://pubmed.ncbi.nlm.nih.gov/31059663/ ★]</span>'''
***'''Patients with symptomatic vesicourethral anastomotic stenosis or bladder neck contracture should be treated prior to surgery for incontinence after prostate therapy'''
****Unrecognized urethral pathologic processes can significantly complicate all surgical approaches
* '''<span style="color:#ff0000">Urodynamics (UDS) may be performed[https://pubmed.ncbi.nlm.nih.gov/31059663/ ★]</span>'''
**'''<span style="color:#ff0000">UDS are not required before surgical intervention for incontinence after prostate therapy unless the clinician is in doubt of the diagnosis or it is felt that patient counseling will be affected.</span>'''
***'''<span style="color:#ff0000">During UDS, it is important that the catheter be removed and stress testing repeated in patients with suspected SUI who do not demonstrate stress incontinence with a catheter in place</span>'''
****'''<span style="color:#ff0000">Up to 35% of males with post-prostatectomy SUI will not demonstrate SUI with a catheter in place. This may be due to some scarring at the site of the anastomosis. In such cases, even a small catheter can occlude the urethra and prevent stress leakage.</span>'''
**'''Intrinsic sphincteric dysfunction will be identified in almost all cases.'''
** '''In 2012''', '''the American Urological Association (AUA) released guidelines on the use of urodynamics''' in the clinical evaluation of the patient with voiding dysfunction.
*** '''Specific recommendations for the patient with SUI include at minimum that: surgeons considering invasive therapy in patients with SUI should assess the PVR'''.
*** Furthermore, clinicians may perform multichannel urodynamics in patients with both symptoms and physical findings of stress incontinence who are considering invasive, potentially morbid or irreversible treatments, which include placement of the male sling or AUS.
** '''Detrusor hypocontractility may indicate the need for AUS instead of sling if adequate detrusor function does not exist to overcome the fixed resistance of a compressive sling'''
** '''Reduced bladder compliance is concerning because prolonged storage at high pressures may lead to deteriorating renal function.'''