Abstract
Background: Benign prostatic hyperplasia (BPH) is characterized by the abnormal proliferation of cells, leading to structural changes. It is one of the most common diseases in ageing men. Its clinical presentations are dominated by lower urinary tract symptoms (LUTS). The therapeutic methods can be grouped into two options: the medical option and the surgical option in which prostate enucleation is found. In recent years many studies have reported the onset of urinary incontinence (UI) after prostate enucleation. The management of UI occurring after prostate enucleation is embarrassing for both the practitioner and the patient, and generates additional costs. Purpose: Cite the causes of UI after prostate enucleation for BPH, as well as ways to prevent the onset of UI after this surgery, specifically by the study of the vesicosphincteric system aimed at improving the technique of enucleation; our review will also deal with the therapeutic means of UI. Method: We retrieved studies from Science Direct, Wiley and Pubmed. Results: There are multiple etiologies of UI after prostate enucleation including urethral sphincter insufficiency (USI) and bladder dysfunction (BD). The management of UI after surgery could be conservative, surgical, or use new technologies. Urodynamic assessment before prostate enucleation for BPH is relevant. Conclusion: UI is a common post-operative complication of prostate enucleation. The study of the vesicosphincteric system leads us to believe that prostate enucleation for BPH, partially sparing the mucosa and the external urethral sphincter could decrease the incidence of UI after surgery.
Highlights
Prostate adenoma or benign prostatic hyperplasia (BPH) is a new formation developed at the expense of prostate gland
Cite the causes of urinary incontinence (UI) after prostate enucleation for Benign prostatic hyperplasia (BPH), as well as ways to prevent the onset of UI after this surgery, by the study of the vesicosphincteric system aimed at improving the technique of enucleation; our review will deal with the therapeutic means of UI
The study of the vesicosphincteric system leads us to believe that prostate enucleation for BPH, partially sparing the mucosa and the external urethral sphincter could decrease the incidence of UI after surgery
Summary
Prostate adenoma or benign prostatic hyperplasia (BPH) is a new formation developed at the expense of prostate gland. In recent years many studies have reported complications related to surgical treatment, including urinary incontinence (UI) [15] [16]; several data reported that temporary UI occurs in more than 20% of patients after prostatic enucleation [17] [18]. Publications revealed some predisposing factors in patients to urinary incontinence after enucleation for BPH including: advanced age, commorbidities (such as diabetes), a large size of the prostate gland, a long operating time, as well as significant blood loss during the operation. There are methods of preventing and treating urinary incontinence after prostatic enucleation for BPH, the prevalence of post-surgical urinary incontinence remains high. Based on the above two considerations, we believe that the mucosa near the external urethral sphincter plays an important role in urinary control; we assume that prostatic enucleation for BPH, partially sparing the mucosa and the external urethral sphincter could decrease the incidence of post-surgical UI. The reduction of urinary incontinence after surgery for BPH would undoubtedly be a source of satisfaction for the surgeon, the patient and an economic gain for society with regard to the diagnosis and management of this urinary incontinence
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