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We truly appreciate your comments. We also believe that results assessment of the device implantation by means of validated questionnaires is needed. Achievement of continence is by itself the most simple and reliable way to define a “success,” but at the same time it risks being an excessively “mechanical” definition with respect to quality of life issues. Indeed, a score obtained from the assessment of urinary function allows for the correct definition of “success,” or not in patients who do not regain complete continence or who become perfectly dry but have an impaired quality of life because of urinary frequency or urgency. We also believe that experience from other surgeons is needed to reliably assess the pros and cons related to the procedure. To our knowledge, results of about 120 patients implanted with the periurethral constrictor have been published to date. 1 de O Vilar F. Araújo L.A. Lima S.V. Periurethral constrictor in pediatric urology: long-term followup. J Urol. 2004; 171: 2626-2628 Abstract Full Text Full Text PDF PubMed Scopus (14) Google Scholar , 2 Schiavini J.L. Damião R. de Resende Júnior J.A. et al. Treatment of post-prostate surgery urinary incontinence with the periurethral constrictor: a retrospective analysis. Urology. 2010; 75: 1488-1492 Abstract Full Text Full Text PDF PubMed Scopus (21) Google Scholar However, this seems a small number. Finally, let us report only about an emerging problem, which is the onset of late incontinence (after a period of continence) or worsening preexisting incontinence in long-term survivors submitted to radical prostatectomy. 3 Naselli A. Simone G. Papalia R. et al. Late-onset incontinence in a cohort of radical prostatectomy patients. Int J Urol. 2011; 18: 76-79 Crossref PubMed Scopus (7) Google Scholar They form a new category of patients, including some of the individuals described in our paper, that is gradually increasing. In general, the problem afflicts elderly people, who frequently carry many comorbidities and are poorly compliant in using the scrotal pump to begin to urinate. They probably would benefit greatly from the periurethral constrictor implantation because it is easy to be positioned, allowing a minimally invasive, fast surgery; it does not need a pump; and it is not expensive. We strongly believe this specific topic could be the object of future interesting studies. Editorial CommentUrologyVol. 79Issue 5PreviewAdvances in surgical technique have greatly improved continence outcomes after radical prostatectomy. Unfortunately, severe and/or bothersome urinary incontinence does occur in some patients. In many cases, this can be unpredictable and a source of anxiety for patients contemplating prostate cancer surgery. Although other options have arisen to handle milder forms of postprostatectomy incontinence, artificial urethral sphincters have been a mainstay in the management of patients with the most severe symptoms. Full-Text PDF