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