Abstract：
Urinary incontinence after prostate treatment (IPT) is one of the few urologic diseases that is iatrogenic, and, therefore, predictable and perhaps preventable. Evaluation of the incontinent patient, risk factors for IPT, the assessment of the patient prior to intervention, and a stepwise approach to management are covered in this guideline. Algorithms for patient evaluation, surgical management, and device failure are also provided.
This guideline was developed using a systematic review from the Mayo Clinic Evidence Based Practice Center with additional supplementation by the authors. A research librarian conducted searches from 2000 to December 21st, 2017 using Ovid, MEDLINE, Cochrane Central Register of Controlled Trials, and Cochrane Databases of Systematic Reviews. Additional references through 12/31/2018 were identified.
This guideline was developed by a multi-disciplinary panel to inform clinicians on the proper assessment of patients with IPT and the safe and effective management of the condition in both surgical and non-surgical contexts. Statements guiding the clinician on proper management of device failure are also included.
Most patients who undergo radical prostatectomy (RP), and some patients who undergo radiation therapy (RT) or surgery for benign prostatic hyperplasia (BPH), will experience IPT. Although non-surgical options, such as pelvic floor muscle exercises (PFME), can hasten continence recovery, patients who remain incontinent at one-year post-procedure, or have severe incontinence at six months, may elect to undergo surgical treatment (e.g. artificial urinary sphincter). Prior to IPT surgery, the risks, benefits, alternatives, and additional likely procedures should be discussed with the patient.
This guideline was developed using a systematic review from the Mayo Clinic Evidence Based Practice Center with additional supplementation by the authors. A research librarian conducted searches from 2000 to December 21st, 2017 using Ovid, MEDLINE, Cochrane Central Register of Controlled Trials, and Cochrane Databases of Systematic Reviews. Additional references through 12/31/2018 were identified.
This guideline was developed by a multi-disciplinary panel to inform clinicians on the proper assessment of patients with IPT and the safe and effective management of the condition in both surgical and non-surgical contexts. Statements guiding the clinician on proper management of device failure are also included.
Most patients who undergo radical prostatectomy (RP), and some patients who undergo radiation therapy (RT) or surgery for benign prostatic hyperplasia (BPH), will experience IPT. Although non-surgical options, such as pelvic floor muscle exercises (PFME), can hasten continence recovery, patients who remain incontinent at one-year post-procedure, or have severe incontinence at six months, may elect to undergo surgical treatment (e.g. artificial urinary sphincter). Prior to IPT surgery, the risks, benefits, alternatives, and additional likely procedures should be discussed with the patient.
摘要：
前列腺治疗后尿失禁（IPT）是少数医源性泌尿系疾病之一，and,因此,可预测的，也许是可以预防的。失禁患者的评估，IPT的危险因素，干预前对患者的评估，本指南涵盖了逐步的管理方法。用于患者评估的算法，手术管理,和设备故障也提供。
本指南是通过梅奥诊所循证实践中心的系统评价以及作者的补充制定的。一名研究馆员从2000年到12月21日进行了搜索，2017年使用奥维德，MEDLINE,Cochrane中央控制试验登记册,和Cochrane系统评价数据库。确定了截至2018年12月31日的其他参考文献。
本指南是由多学科小组制定的，旨在告知临床医生对IPT患者的正确评估以及在手术和非手术环境中对疾病的安全有效管理。还包括指导临床医生正确管理设备故障的声明。
大多数接受根治性前列腺切除术（RP）的患者，和一些接受放射治疗（RT）或手术治疗良性前列腺增生（BPH）的患者，将体验IPT。虽然非手术选择，如盆底肌肉锻炼(PFME)，可以加快节制恢复，术后一年仍有失禁的患者，或者六个月后有严重的尿失禁，可以选择接受手术治疗(例如人工尿道括约肌)。在IPT手术之前,风险,好处,替代品，和其他可能的程序应与患者讨论。
本指南是通过梅奥诊所循证实践中心的系统评价以及作者的补充制定的。一名研究馆员从2000年到12月21日进行了搜索，2017年使用奥维德，MEDLINE,Cochrane中央控制试验登记册,和Cochrane系统评价数据库。确定了截至2018年12月31日的其他参考文献。
本指南是由多学科小组制定的，旨在告知临床医生对IPT患者的正确评估以及在手术和非手术环境中对疾病的安全有效管理。还包括指导临床医生正确管理设备故障的声明。
大多数接受根治性前列腺切除术（RP）的患者，和一些接受放射治疗（RT）或手术治疗良性前列腺增生（BPH）的患者，将体验IPT。虽然非手术选择，如盆底肌肉锻炼(PFME)，可以加快节制恢复，术后一年仍有失禁的患者，或者六个月后有严重的尿失禁，可以选择接受手术治疗(例如人工尿道括约肌)。在IPT手术之前,风险,好处,替代品，和其他可能的程序应与患者讨论。
