Analysis of Biological Factors Causing Urinary Incontinence After Radical Prostatectomy (Literature Review)

Abstract

Purpose: analysis of various biological factors underlying the post-prostatectomy incontinence.Materials and methods. The studies were conducted on the basis of PubMed and EMBASE publications from January 1990 to May 2015. After the initial search, the database consisted of 32 articles that met the inclusion and exclusion criteria.Results. Anatomical elements and pelvic support significantly affect the frequency of post-prostatectomy incontinence (PPI). It has been proven that non-anatomical and surgical elements play an important role in the development mechanisms of PPI. Biological factors and preoperative parameters included: functional changes in the bladder, age, body mass index, presence of lower urinary tract symptoms (LUTS), prostate volume and length of the membranous urethra. Numerous studies have noted the impact of specific surgical factors, including the short length of the membranous urethra, extended dissection of the apex, and insufficient experience of the surgeon. Each of these factors had a negative impact on the status of the continent in patients after radical prostatectomy (RP). Today, research continues on the analysis of preliminary transurethral resection of the prostate gland, hyperactivity of the detrusor and salvage techniques and their impact on the status of the postoperative continent.Conclusion. Based on modern literature, it is proved that biological / preoperative factors, which included an advanced age before surgery, the presence of LUTS, a significant body mass index, the length of the membranous urethra and functional changes in the bladder negatively affect the state of the continent after RP. Excessive dissection of the apex of the prostate gland, large sizes of the prostate gland and hyperactivity of the detrusor are also significant negative factors in urinary retention in patients who underwent RP.