In a revealing interview with Urology Times, Dr. Bashir Al Hussein Al Awamlh shed light on a concerning trend: the shockingly low rates of incontinence procedures after radical prostatectomy (RP). Recent data presented at the American Urological Association 2025 Annual Meeting showed that only 6.2% of patients opted for incontinence interventions, with 4% occurring within the first three years post-surgery.

Alarmingly, half of those procedures involved artificial urinary sphincters. These statistics mirror past studies, indicating this low utilization has remained consistent over time.

Dr. Al Awamlh pointed out the difficulty in conclusively labeling this trend as underutilization, yet confirmed that those who did pursue the procedures were primarily those in dire need, based on their self-reported outcomes. While incontinence is a known complication post-prostatectomy, future investigations could shed light on whether advances in surgical techniques and growing surgeon expertise might enhance patient outcomes.

This calls for a proactive stance in identifying and referring patients suffering from poor urinary function post-RP. Dr. Al Awamlh emphasized the importance of using validated questionnaires for surgeons monitoring patients. These tools can help identify individuals reporting persistent low outcomes at the 6- or 12-month mark, allowing for timely referrals to specialists. Early intervention is key in managing expectations and reducing the risk of patient regret.

Looking ahead, upcoming research will build on the CEASAR study, aiming to connect patient-reported outcomes to claims data. This will help pinpoint which patients might benefit from secondary procedures, along with assessing if these interventions result in an improved quality of life.