Comparison of Different Invasive Devices for the Treatment of Urinary Incontinence after Radical Prostatectomy
Purpose. To compare different forms of invasive treatments for postradical prostatectomy (RP) urinary incontinence (UI) in terms of quantitative and qualitative parameters and continence recovery rate. Methods. We distinguished five categories of treatment: A = bulking agents, B = fixed slings, C = ...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Advances in Urology |
| Online Access: | http://dx.doi.org/10.1155/2022/8736249 |
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| author | Stefano Salciccia Pietro Viscuso Giulio Bevilacqua Antonio Tufano Paolo Casale Ettore De Berardinis Giovanni Battista Di Pierro Susanna Cattarino Alessandro Gentilucci Francesca Lourdes Lia Di Giulio Ivan Davide Rosati Francesco Del Giudice Alessandro Sciarra Gianna Mariotti |
| author_facet | Stefano Salciccia Pietro Viscuso Giulio Bevilacqua Antonio Tufano Paolo Casale Ettore De Berardinis Giovanni Battista Di Pierro Susanna Cattarino Alessandro Gentilucci Francesca Lourdes Lia Di Giulio Ivan Davide Rosati Francesco Del Giudice Alessandro Sciarra Gianna Mariotti |
| author_sort | Stefano Salciccia |
| collection | DOAJ |
| description | Purpose. To compare different forms of invasive treatments for postradical prostatectomy (RP) urinary incontinence (UI) in terms of quantitative and qualitative parameters and continence recovery rate. Methods. We distinguished five categories of treatment: A = bulking agents, B = fixed slings, C = adjustable slings, D = circumferential compressor devices (artificial sphincter), and E = noncircumferential compressor devices (ProACT). A literature search was performed following the PRISMA guidelines. We performed a cumulative meta-analysis to explore the trend in the effect sizes across groups at postoperative follow-up. We compared the available treatment arms using standardized mean difference (SMD) and event rate (ER) for questionnaire results, number of pads/day, and percentage of pad-free patients. Evidence synthesis. 36 clinical trials were selected. At baseline, in the different populations, mean number of pad-day varied from 1.1 to 8.8, 24-hour pad weight varied extremely from 17.3 g to 747.0 g, and mean ICIQ-UI-SF questionnaire score varied from 4.8 to 18.6. Considering a random effect model among eligible studies, ER of continence recovery was 0.33 (95% CI −0.12–0.78), 0.63 (95% CI 0.55–0.71), 0.65 (95% CI 0.58–0.72), 0.50 (95% CI 0.34–0.66), and 0.53 (95%CI 0.36–0.70), respectively, in groups A, B, C, D, and E (I2 85.87%; Q 249.82—P>0.01) (test of group differences P=0.22). Conclusion. In our analysis, the use of adjustable and fixed slings is associated with the highest whereas the use of bulking agents is associated with the lowest recovery rate of continence after treatment. Results are conditioned by an elevated rate of heterogeneity in part explained with a high variability of consistence in urinary leakage at baseline among populations. |
| format | Article |
| id | doaj-art-f9d2c2f8155c44718afaaad0c9d2df4c |
| institution | Kabale University |
| issn | 1687-6377 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Advances in Urology |
| spelling | doaj-art-f9d2c2f8155c44718afaaad0c9d2df4c2025-02-03T01:32:35ZengWileyAdvances in Urology1687-63772022-01-01202210.1155/2022/8736249Comparison of Different Invasive Devices for the Treatment of Urinary Incontinence after Radical ProstatectomyStefano Salciccia0Pietro Viscuso1Giulio Bevilacqua2Antonio Tufano3Paolo Casale4Ettore De Berardinis5Giovanni Battista Di Pierro6Susanna Cattarino7Alessandro Gentilucci8Francesca Lourdes Lia9Di Giulio Ivan10Davide Rosati11Francesco Del Giudice12Alessandro Sciarra13Gianna Mariotti14Department of Maternal-Infant and Urologic SciencesDepartment of Maternal-Infant and Urologic SciencesDepartment of Maternal-Infant and Urologic SciencesDepartment of Maternal-Infant and Urologic SciencesDepartment of UrologyDepartment of Maternal-Infant and Urologic SciencesDepartment of Maternal-Infant and Urologic SciencesDepartment of Maternal-Infant and Urologic SciencesDepartment of Maternal-Infant and Urologic SciencesDepartment of Maternal-Infant and Urologic SciencesDepartment of Maternal-Infant and Urologic SciencesDepartment of Maternal-Infant and Urologic SciencesDepartment of Maternal-Infant and Urologic SciencesDepartment of Maternal-Infant and Urologic SciencesDepartment of Maternal-Infant and Urologic SciencesPurpose. To compare different forms of invasive treatments for postradical prostatectomy (RP) urinary incontinence (UI) in terms of quantitative and qualitative parameters and continence recovery rate. Methods. We distinguished five categories of treatment: A = bulking agents, B = fixed slings, C = adjustable slings, D = circumferential compressor devices (artificial sphincter), and E = noncircumferential compressor devices (ProACT). A literature search was performed following the PRISMA guidelines. We performed a cumulative meta-analysis to explore the trend in the effect sizes across groups at postoperative follow-up. We compared the available treatment arms using standardized mean difference (SMD) and event rate (ER) for questionnaire results, number of pads/day, and percentage of pad-free patients. Evidence synthesis. 36 clinical trials were selected. At baseline, in the different populations, mean number of pad-day varied from 1.1 to 8.8, 24-hour pad weight varied extremely from 17.3 g to 747.0 g, and mean ICIQ-UI-SF questionnaire score varied from 4.8 to 18.6. Considering a random effect model among eligible studies, ER of continence recovery was 0.33 (95% CI −0.12–0.78), 0.63 (95% CI 0.55–0.71), 0.65 (95% CI 0.58–0.72), 0.50 (95% CI 0.34–0.66), and 0.53 (95%CI 0.36–0.70), respectively, in groups A, B, C, D, and E (I2 85.87%; Q 249.82—P>0.01) (test of group differences P=0.22). Conclusion. In our analysis, the use of adjustable and fixed slings is associated with the highest whereas the use of bulking agents is associated with the lowest recovery rate of continence after treatment. Results are conditioned by an elevated rate of heterogeneity in part explained with a high variability of consistence in urinary leakage at baseline among populations.http://dx.doi.org/10.1155/2022/8736249 |
| spellingShingle | Stefano Salciccia Pietro Viscuso Giulio Bevilacqua Antonio Tufano Paolo Casale Ettore De Berardinis Giovanni Battista Di Pierro Susanna Cattarino Alessandro Gentilucci Francesca Lourdes Lia Di Giulio Ivan Davide Rosati Francesco Del Giudice Alessandro Sciarra Gianna Mariotti Comparison of Different Invasive Devices for the Treatment of Urinary Incontinence after Radical Prostatectomy Advances in Urology |
| title | Comparison of Different Invasive Devices for the Treatment of Urinary Incontinence after Radical Prostatectomy |
| title_full | Comparison of Different Invasive Devices for the Treatment of Urinary Incontinence after Radical Prostatectomy |
| title_fullStr | Comparison of Different Invasive Devices for the Treatment of Urinary Incontinence after Radical Prostatectomy |
| title_full_unstemmed | Comparison of Different Invasive Devices for the Treatment of Urinary Incontinence after Radical Prostatectomy |
| title_short | Comparison of Different Invasive Devices for the Treatment of Urinary Incontinence after Radical Prostatectomy |
| title_sort | comparison of different invasive devices for the treatment of urinary incontinence after radical prostatectomy |
| url | http://dx.doi.org/10.1155/2022/8736249 |
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