Urinary incontinence after prostatectomy for benign or malignant disease is a well known and often feared outcome. Although a small amount of incontinence may not cause a problem, larger degrees of incontinence can have a major impact on a man's quality of life. Improvement in urinary continence may occur six to 12 months after the prostatic surgery, but for men with persistent bothersome incontinence despite conservative therapy, surgery may be offered.
This review looked for trials that had considered the effectiveness of the surgical treatments of urinary incontinence after prostate surgery. There are five main types of surgery and, despite some of them being in use for more than two decades, only one trial that met the inclusion criteria was found. There was some weak evidence that the implantation of an artificial urinary sphincter might be more effective than injectable treatment, but with more adverse effects and higher costs. There was no evidence about the other types of surgery.