Post-prostatectomy urinary incontinence is a frequent problem in prostate cancer survivors regardless of the surgical technique used (open, laparoscopic or robotic), with 5-6% patients requiring surgery for this complication (1)

Basic evaluation of patients with urinary incontinence after radical prostatectomy should include anamnesis and physical examination, 1-3 days voiding diary, 24-hour pad test, urethrocystoscopy and urodynamic study.
Treatment options, once the conservative measures have failed, are fixed slings, adjustable slings, compression devices and artificial sphincters (2)

The decision to use one technique or another will depend on several factors: severity of the incontinence, urethral / sphincter complex status, cognitive level, manual dexterity, patient expectations and surgeon preferences (3)

In our center we use three devices / techniques for the management of post-prostatectomy urinary incontinence:
1. Retrourethral transobturator sling (AdVanceXP)
2. Readjustable suburethral male sling (Remeex)
3. Artificial urinary sphincter (AMS 800 or ZSI 375)
In this video, we present the key steps of each technique.

Kim PH, Pinheiro LC, Atoria CL et al: Trends in the use of incontinence procedures after radical prostatectomy: a population based analysis. J Urol 2015; 189: 602.
Herschorn S, Bruschini H, Comiter C et al: Surgical treatment of stress incontinence in men. Neurourol Urodyn 2010; 29: 179.
Bauer RM, Bastian PJ, Gozzi Ch, Stief ChG. Postprostatectomy Incontinence: All About Diagnosis and Management. Eur Urol 2009; 55: 322.