AUA: Incontinence after Prostate Therapy (2024): Difference between revisions

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 **# '''<span style="color:#ff0000">//Prior pelvic radiation</span>'''
 **#* '''Radiation is a significant risk factor for IPT in patients undergoing RP or TURP.'''
-**#** '''These patients should be informed that they may require an artificial urinary sphincter (AUS).'''
+**#** The urethral fibrosis developing from radiation-related progressive endarteritis decreases the functional capabilities of the external sphincter.
+**#*** Even in the absence of direct damage to the sphincter, adjacent surgical cautery or laser energy further compromises sphincter function.
+**#** TURP following brachytherapy or external beam radiation has been associated with  incontinence rates of up to 70%
+**#** The need for subsequent resections, patient age, and pre-TURP urgency is correlated with higher rates of incontinence.
+**#** Little to no published evidence discussing post-TURP outcomes with patients who have undergone other forms of local therapy such as HIFU and cryotherapy; these patients likely have high risks of incontinence similar to post-TURP radiated patients.
+**#*Regardless of the initial form of non-operative therapy or the operative approach, salvage RP is associated with high rates of urinary incontinence rates for both open and robotic techniques compared to standard RP.
+**#*Patients undergoing TURP or salvage RP after primary non-surgical treatment for prostate cancer who seek long-term continence should be informed that they may require an artificial urinary sphincter (AUS).
 *** '''<span style="color:#ff0000">Surgical approach: open RP has similar rates of urinary incontinence as robot-assisted RP</span>'''
 *** '''<span style="color:#ff0000">BMI may impact IPT in the short-term; however, not considered to impact risk at 1-year after RP</span>'''