Sir

Post-radical prostatectomy urinary incontinence can greatly impact on the quality of life of a man who is otherwise fit and well. Doherty and Almallah have reviewed an important topic concisely. From our experience, we feel that AUS devices can also play a role in another important patient group.

Salvage radical prostatectomy (SRP) offers a select population of men who fail radiotherapy as primary treatment for localised prostate cancer a chance of cure.

We have successfully treated severe urinary incontinence after SRP. SRP is a technically challenging operation with a greater risk of morbidity, particularly incontinence, than radical prostatectomy for primary treatment due to indistinct dissection planes and tissue fibrosis following radiotherapy.

Our tertiary referral centre has experienced an increasing number of referrals for SRP in men with biopsy-proven recurrent prostate cancer after radiotherapy. Owing to greater detection of organ-confined prostate cancer and increasing life expectancy, we expect this trend to continue and have thus recently drafted a national protocol for equitable consideration for SRP.

Pelvic floor exercises shall undoubtedly continue to be the mainstay of treatment for incontinence post-SRP. In future more men may wish to consider SRP in the knowledge that an AUS could cure their incontinence, rather than persevering with pads or external collecting devices.

Competing interests: None declared