Bulking Agents for Urinary and Fecal Incontinence

Abstract

Male stress urinary incontinence (SUI) is most commonly a consequence of prostatic surgery except when symptoms are driven by a neurological concomitant condition. Hence, compared to what urologists know about current clinical practice in female SUI, the diagnostic phase in men is a very particular and important step in the management of the disease, with accurate evaluation of the clinical context, SUI cause, quality of life assessment, and patient complaints [1, 2]. Improvements in urinary leakage after prostatic surgery (RP and TURP) may occur spontaneously or with conservative measures within the first 12 months after surgery. However, management of persistent incontinence is often challenging and may be frustrating for both a patient and his doctor, and as a consequence, it can negatively affect patients’ quality of life and doctor–patient relationship [3]. Urinary incontinence causes problems, such as poor hygiene and loss of self-confidence that directly affect the quality of life of patients. The mechanism for male SUI after prostate surgery appears to be internal sphincter deficiency. The probable mechanism for internal sphincter deficiency after prostate surgery includes rhabdo-sphincter injury during apical dissection, large and deep sutures during vesico-urethral anastomosis, or injury of the neurovascular bundles [3].