Chirurgia128

Nietrzymanie moczu po prostatektomii: czynniki ryzyka, rehabilitacja i opcje chirurgiczne

Post-Prostatectomy Incontinence: Risk Factors, Rehabilitation, and Surgical Options

Cyryl Rabcewicz✉1Mateusz Marcinek1

1Specialist Voivodeship Hospital of Saint Barbara No. 5 in Sosnowiec - Trauma Center Plac Medyków 1, 41-214 Sosnowiec, PL

✉Cyryl Rabcewicz

Otrzymano: 21.07.2025Zaakceptowano: 30.07.2025Opublikowano: 03 sierpnia 2025
e-ISSN: 2084-2708 (wersja pierwotna)p-ISSN: 2083-0033 (wersja drukowana)
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Streszczenie

Wstęp

Nietrzymanie moczu po prostatektomii (PPI) to uciążliwe powikłanie dotykające mężczyzn po radykalnej prostatektomii, znacząco obniżające jakość życia. Pomimo postępów w technikach chirurgicznych, PPI pozostaje istotnym problemem w praktyce urologicznej.

Opis przypadku

Cel: Celem niniejszego przeglądu jest kompleksowa analiza aktualnego stanu wiedzy na temat PPI, ze szczególnym uwzględnieniem czynników ryzyka, metod diagnostycznych, podejść rehabilitacyjnych i opcji chirurgicznych. Metody: Przeprowadzono przegląd literatury z wykorzystaniem recenzowanych artykułów z bazy PubMed (2015–2024), autorytatywnych podręczników urologii i aktualnych wytycznych klinicznych. Priorytetowo traktowano badania kohortowe, przeglądy systematyczne i randomizowane badania kontrolowane.

Wnioski

Skuteczne leczenie PPI wymaga podejścia multidyscyplinarnego, opartego na wczesnej diagnostyce, edukacji pacjenta i terapii dostosowanej indywidualnie. Nowe techniki regeneracyjne i neuromodulacyjne mogą w przyszłości stanowić alternatywę dla obecnych metod leczenia.
Słowa kluczowe:post-prostatectomy incontinenceradical prostatectomyurinary incontinencemale slingartificial urinary sphincterpelvic floor rehabilitation

Abstract

Introduction

Post-prostatectomy incontinence (PPI) is a distressing complication affecting men following radical prostatectomy, significantly impairing quality of life. Despite advances in surgical techniques, PPI remains a prevalent concern in urologic practice.

Case Report

Radical prostatectomy is a cornerstone of curative therapy for localized prostate cancer, offering favorable oncologic outcomes in appropriately selected patients. However, one of its most common and distressing complications is post-prostatectomy incontinence (PPI), with reported rates ranging from 4% to 40% depending on the definition used, the surgical technique, and the timing of assessment. (1,2) This complication significantly impacts health-related quality of life, causing physical discomfort, emotional distress, and social withdrawal.(3)

Conclusions

Managing PPI requires a multidisciplinary approach rooted in early diagnosis, patient education, and individualized therapy. Emerging regenerative and neuromodulatory techniques may offer future alternatives.
Keywords:post-prostatectomy incontinenceradical prostatectomyurinary incontinencemale slingartificial urinary sphincterpelvic floor rehabilitation

Piśmiennictwo

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