Instructional Course - Requires Course Pass or Individual Course Ticket, Additional Registration Required
There are currently no approved guidelines regarding the management of post-prostatectomy urinary incontinence. However, given the increased use of robotic assisted laparoscopic radical prostatectomy, the prevalence of post-prostatectomy incontinence continues to rise. We propose an evidence-based course that recommends a logical and straightforward evaluation of the incontinent male, including history, physical examination, radiographic evaluation, and urodynamic testing. Once the pathophysiology is determined, then the patient and urologist can arrive at a treatment plan that may include physical therapy, pharmacotherapy, and/or surgery. When conservative management fails, depending on the bladder and outlet function and dysfunction, the urologist can offer surgical intervention. There are a plethora of surgical devices, including a variety of male slings and the artificial sphincter, each with their own advantages and disadvantages, We will give an evidence-based recommendation regarding the ideal evaluation, and best surgical options for a particular type of patient, based on bladder activity (detrusor overactivity versus stable, normal versus weak contractility) and sphincteric function (mobile versus fixed, present versus absent residual sphincter function) and urethral integrity (radiated versus non-radiated). We will give a case-based discussion regarding best practices, trouble-shooting postoperative complications, managing persistent or recurrent incontinence, and indications for and techniques for surgical re-intervention.
Teaching techniques will include didactic lectures, surgical videos, and display of various devices.