Radikal Prostatektomi Sonrası Oluşan İdrar Kaçırma Patogenezi ve Güncel Tedavi Yaklaşımları

Organa sınırlı prostat kanserinde altın standart tedavi seçeneği radikal prostatektomidir. RP sonrası en önemli komplikasyonlardan biri idrar kaçırma olup cerrahi teknik, hasta yaşı, sinir-koruyucu uygulama ve anastamoz tekniği gibi pek çok faktör patogenezde rol oynayabilir. Prostatektomi sonrası oluşan idrar kaçırma tedavisi, konservatif yöntemlerden invaziv girişimlere kadar değişen farklı metodlar kullanılarak yapılmaktadır. Pelvik taban egzersizleri, farmakolojik ajanlar, kollajen enjeksiyonu, sling cerrahisi, ayarlanabilir teknikler, artifisyel sfinkter ve yeni geliştirilen yöntemler tedavideki bazı uygulamalardır. Bu çalışmada, Radikal prostatektomi sonrası oluşan idrar kaçırmada anatomik ve patofizyolojik faktörler ile tedavide uygulanan güncel yöntemler gözden geçirilmiştir.©2008, Fırat Üniversitesi, Tıp Fakültesi

Anahtar Kelimeler:

Radikal prostatektomi, idrar kaçırma, tedavi, cerrahi

Pathophysiology of Post-prostatectomy Urinary Incontinence and Current Treatment Approaches

Radical prostatectomy, is the gold standard modality in the treatment of organ confined prostate cancer. Urinary incontinence is one of the most bothersome complication after RP and several factors such as, surgical technique, patient age, nerve-sparing and anastomosis technique play role in the pathogenesis. Management of incontinence due to prostatectomy includes several methods which differ from conservative to invasive methods. Pelvic floor exercises, pharmacological agents, collagen injection, sling surgeries, adjustable methods, artificial urinary sphincter and new modalities are among these. In this review, anatomical and pathophysiological factors in the development of post-prostatectomy incontinence, as well as current treatment modalities are reviewed. ©2008, Fırat Üniversitesi, Tıp Fakültesi

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Kabul Tarihi: 26.11.2007