American Urological Association Releases Incontinence after Prostate Treatment Guideline Amendment
June 27 2024 - 10:52AM
Today, the American Urological Association (AUA), in partnership
with the Society of Genitourinary Reconstructive Surgeons (GURS)
and the Society of Urodynamics, Female Pelvic Medicine &
Urogenital Reconstruction (SUFU), released the 2024 amendment to
the Incontinence after Prostate Treatment (IPT) Guideline.
This guideline on IPT is intended to facilitate care decisions
and aid clinicians in the management of patients who have
incontinence after undergoing treatment for localized prostate
cancer and benign prostatic hyperplasia (BPH). The multiple
treatments that exist for patients with IPT are discussed,
evaluated and updated within this amendment.
“Urinary incontinence is a prevalent and highly impactful
quality of life issue that can cause stress, depression and social
isolation if left untreated. We hope this amendment serves as a
useful resource for clinicians who treat stress incontinence in men
after prostate therapies such as prostatectomy, radiation and
benign prostatic hypertrophy surgery,” said Guideline Amendment
Chair Benjamin N. Breyer, MD, MAS, FACS, professor and chair of
urology at the University of California San Francisco. “We’ve
provided guidance on the impact of radiation on urinary health as
well as suggestions for counseling men about the risk factors for
artificial urinary sphincter erosion, among other
recommendations.”
The guideline has 38 recommendations and serves as a useful
reference on effective evidence-based care as it relates to
incontinence after prostate treatment.
This amendment includes:
- Pre-treatment updates to be more inclusive of patients who will
undergo treatments other than radical prostatectomy.
- Treatment updates that include new evidence on adjustable
balloon devices and the efficacy and outcomes of slings.
- New discussion of counseling patients regarding risk factors of
artificial urinary sphincter erosion.
- New guidance on explanation in patients presenting with
infection or erosion of an artificial urinary sphincter or
sling.
- Updated future directions discussing ongoing research in the
field and potential future treatment options.
“Despite a decline in PSA screening, increased use of active
surveillance and refinements in curative therapies, incontinence
remains a profound issue after prostate cancer treatment. The
increasing use of radical prostatectomy in patients with high-risk
cancer and salvage local therapies has resulted in increased
complexity and complication risk in patients presenting with
urinary incontinence after prostate treatment,” said Keith Rourke,
MD, FRCSC, president of GURS. “This AUA guideline provides
up-to-date, evidence-based recommendations on the best way to
evaluate, counsel, stratify and optimize outcomes for patients with
this challenging condition.”
“Incontinence following prostate treatment is a significant
concern that profoundly affects the quality of life for many
patients. This updated guideline aims to equip clinicians with the
latest evidence-based strategies to manage and treat this condition
effectively,” said James Quentin Clemens, MD, president of SUFU.
“By addressing the complexities of post-treatment incontinence,
including the impact of radiation and the risks associated with
artificial urinary sphincters, we strive to improve patients'
outcomes and quality of life.”
The full guideline is now available at
auanet.org/IncontinenceAfterProstateTreatment
A summary of the Guideline also appears at:
Breyer BN, Kim SK, Kirkby E, Marianes A, Vanni AJ, Westney OL.
Updates to Incontinence After Prostate Treatment: AUA/GURS/SUFU
Guideline (2024). J Urol. Published online July 27, 2024.
doi:10.1097/JU.0000000000004088
https://www.auajournals.org/doi/10.1097/JU.0000000000004088
About the American Urological Association: Founded in
1902 and headquartered near Baltimore, Maryland, the American
Urological Association is a leading advocate for the specialty of
urology, and has more than 25,000 members throughout the world. The
AUA is a premier urologic association, providing invaluable support
to the urologic community as it pursues its mission of fostering
the highest standards of urologic care through education, research
and the formulation of health policy.
Corey Del Bianco
American Urological Association
443-909-4033
cdelbianco@auanet.org