Urol. praxi. 2026;27(3):144-148 | DOI: 10.36290/uro.2026.030

Current treatment options for urinary incontinence after radical prostatectomy: from rehabilitation to implantable systems

MUDr. Martin Pollák¹, MUDr. Pavel Navrátil, Ph.D., FEBU^{1, 2}

¹ Urologická klinika, Fakultní nemocnice Hradec Králové

² Lékařská fakulta Univerzity Karlovy v Hradci Králové

Urinary incontinence after radical prostatectomy remains one of the most important functional complications of prostate cancer treatment. Although surgical technique and perioperative care continue to improve, a subset of patients experience persistent urine leakage long after surgery. Effective management requires differen­tiation between predominantly stress incontinence and urgency-predominant or mixed symptoms, together with assessment of leakage severity, spontaneous recovery over time, prior radiotherapy, possible urethral or vesicourethral patho­logy, and patient expectations. Contemporary treatment is stepwise: in the early postoperative period, conservative management based on supervised pelvic floor muscle training and supportive measures remains the cornerstone, whereas persistent moderate or severe stress urinary incontinence should prompt consideration of surgical treatment. The artificial urinary sphincter remains the reference option with the highest probability of complete or social continence, albeit at the cost of a higher likelihood of revision procedures. Male sling systems provide a less invasive alternative for carefully selected patients, particularly those with mild-to-moderate leakage and no prior radiotherapy. More recent studies also suggest a potential role for electrical stimulation and other neuromodulatory approaches as adjuncts to pelvic floor rehabilitation. The aim of this review is to summarise current diagnostic and therapeutic options for post-prostatectomy incontinence with an emphasis on practical use in everyday urological practice.

Keywords: radical prostatectomy, urinary incontinence, post-prostatectomy incontinence, artificial urinary sphincter, male sling, pelvic floor muscle training.

Accepted: October 21, 2026; Published: October 21, 2026  Show citation