Post-RP incontinence: Low procedure rates examined

In a recent interview with Urology Times, Bashir Al Hussein Al Awamlh, MD, MPH, discussed the relatively low utilization of incontinence procedures post-radical prostatectomy (RP). Data from a recent study presented at the American Urological Association 2025 Annual Meeting indicate that approximately 6.2% of patients underwent an incontinence procedure, with the majority (4%) occurring within the first 3 years after RP. Half of these procedures involved the placement of artificial urinary sphincters. These findings are consistent with previous datasets and older cohorts, suggesting stable utilization over time.

Al Awamlh noted that it is challenging to definitively determine underutilization. However, the patients who did undergo these procedures were those who required them most, based on their self-reported outcomes. Although incontinence is known to occur after prostatectomy, future research will explore whether outcomes improve with evolving surgical techniques and increased surgeon skill.

The findings strongly support a proactive approach to identifying and referring patients with poor urinary function after RP. Al Awamlh emphasized that surgeons following patients should use validated questionnaires to objectively identify those with consistently low patient-reported outcomes at 6 or 12 months. Identifying these patients early allows for timely referral to specialists, which is crucial for setting realistic expectations and preventing regret.

Future research will build upon the CEASAR study by linking patient-reported outcomes with claims data to identify which patients require secondary procedures and whether these procedures improve their quality of life.

REFERENCE

1. Al Awamlh BAH, An A, Huang L-C, et al. Association between patient-reported outcomes and use of incontinence procedures following radical prostatectomy: A population-based analysis from the CEASAR study. J Urol. 2025;213(suppl_5s):e238.doi:10.1097/01.JU.0001109784.58660.a5.17