ICS teaching module: Urodynamic testing for patients with post radical prostatectomy urinary incontinence

Abstract

Aim: To present the body of evidence on the practice of assessment and diagnosis of lower urinary tract dysfunction (LUTD) in post radical prostatectomy urinary incontinence (PRP-UI). This serves as a scientific background overview for a presentation made available on the International Continence Society (ICS) website. Methods: ICS-Teaching module prepared by an ad-hoc working group instituted by the ICS Urodynamics Committee using an expert literature review focusing on guidelines and clinical practice and consensus formation by the members of the working group. Finally, the content was reviewed by the core members of the ICS Urodynamics and Standardisation Steering Committees. Results: In addition to non-invasive initial assessment of PRP-UI, clinical practice guidelines state that a specialist (urologist-) assessment includes performing or considering invasive urodynamics to evaluate LUT functions before surgical treatment. We explain the practical elements and consequences of this. Conclusions: This module provides expert guidance on the diagnosis of dysfunction in patients with signs and symptoms of PRP-UI. The coexistence of (other) LUTD with UI is plausibly relevant to management selection, although prospective evidence for this is understudied. Standard urodynamic techniques can be used but should in certain cases be adapted and supplemented for the testing of patients with PRP-UI.