Urethral Bulking and Salvage Techniques for Post-Prostatectomy Incontinence

Purpose of ReviewDespite limited evidence and efficacy, urethral bulking remains a common treatment for post-prostatectomy stress urinary incontinence (PP-SUI). Herein we provide an overview of the existing evidence for synthetic bulking agents and emerging evidence for stem cell-based sphincter rejuvenation in this setting. We also touch upon salvage techniques for management of PP-SUI after failed anti-incontinence interventions.Recent FindingsAutologous stem cell (ASC) therapies are currently undergoing phase III trials for use in female SUI and are poised to enter the market within the next decade. Early data suggests that they may have a future role in PP-SUI management as well. The artificial urinary sphincter (AUS) has emerged as the standard of care for salvage PP-SUI treatment.SummaryTreatment paradigms for PP-SUI continue to evolve. Synthetic bulking remains common while autologous bulking looms as a potential future therapy. The AUS remains the last line of defense.