Patients experience with the use of a penile clamp in post-prostatectomy incontinence – a prospective pilot study
DOI:
https://doi.org/10.2340/sju.v59.9586Keywords:
Incontinence, Radical Prostatectomy, Conservative treatment, Quality of Life(QoL), New devices, Penile clampAbstract
Objectives: The aim of this study was to assess the efficacy of a penile clamp in managing urinary incontinence (UI) and its impact on perceived quality of life (QoL) amongst post-prostatectomy patients.
Material and methods: A prospective pilot study was conducted including patients with post-prostatectomy UI treated with a penile clamp. Inclusion criteria consisted of UI after radical prostatectomy, good hand function, full cognitive function and a minimum penile length of 3 cm and a circumference of 5 cm. An appropriately sized penile clamp was selected during the first visit, and patients were given instructions on how to use it. The first follow-up was a scheduled phone call 1 week after the initial visit. Formal evaluations were performed prior to use of the penile clamp and again after 3 months of usage. These consisted of weighing pads during the daytime with evaluation of leakage, International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), incontinence-QoL (I-QoL) and a questionnaire specific for the penile clamp.
Results: There were 22 patients included, and two were excluded due to reduced hand function and surgery before the study endpoint. The results showed a significant median reduction of urinary leakage of 57% at rest and 58% during physical activity. One complication was observed, as one patient developed a pinching ulcer, after extensive usage. ICIQ-SF showed an increase of 6% for the included patients (n = 20). Ten patients were satisfied with the clamp, and 15 would recommend the clamp to others.
Conclusion: The penile clamp shows promising results in reducing leakage with minimal risks of complications. It can be used as a treatment for patients awaiting surgery. However, patient selection is important regarding hand function, cognitive function and the penile anatomy.
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References
Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–249.
https://doi.org/10.3322/caac.21660 DOI: https://doi.org/10.3322/caac.21660
Radadia KD, Farber NJ, Shinder B, Polotti CF, Milas LJ, Tunuguntla H. Management of postradical prostatectomy urinary incontinence: a review. Urology. 2018;113:13–19.
https://doi.org/10.1016/j.urology.2017.09.025 DOI: https://doi.org/10.1016/j.urology.2017.09.025
Clark CB, Kucherov V, Klonieck E, Shenot PJ, Das AK. Management of urinary incontinence following treatment of prostate disease. Can J Urol. 2021;28(S2):38–43.
Anderson CA, Omar MI, Campbell SE, Hunter KF, Cody JD, Glazener CM. Conservative management for postprostatectomy urinary incontinence. Cochrane Database Syst Rev. 2015;1(1):CD001843.
https://doi.org/10.1002/14651858.CD001843.pub5 DOI: https://doi.org/10.1002/14651858.CD001843.pub5
Rahnama’i MS, Marcelissen T, Geavlete B, Tutolo M, Hüsch T. Current management of post-radical prostatectomy urinary incontinence. Front Surg. 2021;8:647656.
https://doi.org/10.3389/fsurg.2021.647656 DOI: https://doi.org/10.3389/fsurg.2021.647656
Patrick DL, Khalaf KM, Dmochowski R, Kowalski JW, Globe DR. Psychometric performance of the incontinence quality-of-life questionnaire among patients with overactive bladder and urinary incontinence. Clin Ther. 2013;35(6):836–845.
https://doi.org/10.1016/j.clinthera.2013.04.013 DOI: https://doi.org/10.1016/j.clinthera.2013.04.013
Avery K, Donovan J, Peters TJ, Shaw C, Gotoh M, Abrams P. ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourol Urodyn. 2004;23(4):322–330.
https://doi.org/10.1002/nau.20041 DOI: https://doi.org/10.1002/nau.20041
Cheng MC, Liu SP, Chuang YC, Hsu KCP, Chow PM. Prevalence and impacts of male urinary incontinence on quality of life, mental health, work limitation, and health care seeking in China, Taiwan, and South Korea (LUTS Asia): Results from a cross-sectional, population-based study. Investig Clin Urol. 2022;63(1):71–82.
https://doi.org/10.4111/icu.20210259 DOI: https://doi.org/10.4111/icu.20210259
Marchioni M, Primiceri G, Castellan P, et al. Conservative management of urinary incontinence following robot-assisted radical prostatectomy. Minerva Urol Nefrol. 2020;72(5):555–562.
https://doi.org/10.23736/S0393-2249.20.03782-0 DOI: https://doi.org/10.23736/S0393-2249.20.03782-0
Dmochowski RR. Duloxetine: a summary of published clinical experience. Rev Urol. 2004;6(Suppl 3):S56–S63.
Schifano N, Capogrosso P, Tutolo M, Dehò F, Montorsi F, Salonia A. How to prevent and manage post-prostatectomy incontinence: a review. World J Mens Health. 2021;39(4):581–597.
https://doi.org/10.5534/wjmh.200114 DOI: https://doi.org/10.5534/wjmh.200114
Collette ERP, Klaver SO, Lissenberg-Witte BI, Van den Ouden D, Van Moorselaar RJA, Vis AN. Patient reported outcome measures concerning urinary incontinence after robot assisted radical prostatectomy: development and validation of an online prediction model using clinical parameters, lower urinary tract symptoms and surgical experience. J Robot Surg. 2021;15(4):593–602.
https://doi.org/10.1007/s11701-020-01145-9 DOI: https://doi.org/10.1007/s11701-020-01145-9
Kurimura Y, Haga N, Yanagida T, et al. The preoperative pad test as a predictor of urinary incontinence and quality of life after robot-assisted radical prostatectomy: a prospective, observational, clinical study. Int Urol Nephrol. 2020;52(1):67–76.
https://doi.org/10.1007/s11255-019-02301-3 DOI: https://doi.org/10.1007/s11255-019-02301-3
Barnard J, Westenberg AM. The penile clamp: medieval pain or makeshift gain? Neurourol Urodyn. 2015;34(2):115–116.
https://doi.org/10.1002/nau.22597 DOI: https://doi.org/10.1002/nau.22597
Levy A, Fader M, Bader D, Gefen A. Penile compression clamps: A model of the internal mechanical state of penile soft tissues. Neurourol Urodyn. 2017;36(6):1645–1650.
https://doi.org/10.1002/nau.23172 DOI: https://doi.org/10.1002/nau.23172
Lee A, Mmonu NA, Thomas H, Rios N, Enriquez A, Breyer BN. Qualitative analysis of Amazon customer reviews of penile clamps for male urinary incontinence. Neurourol Urodyn. 2021;40(1):384–390.
https://doi.org/10.1002/nau.24572 DOI: https://doi.org/10.1002/nau.24572
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