1.Clinicians should inform patients undergoing radical prostatectomy of all known factors that could affect continence. (Moderate Recommendation; Evidence Level: Grade B)
1. 應(yīng)向接受根治性前列腺切除術(shù)的患者告知所有能夠影響尿控的已知因素。（中等推薦；證據(jù)等級：B）
2.Clinicians should counsel patients regarding the risk of sexual arousal incontinence and climacturia following radical prostatectomy. (Strong Recommendation; Evidence Level: Grade B)
2. 應(yīng)與患者商議關(guān)于根治性前列腺切除術(shù)后性興奮期及性高潮期遺尿的風險。（強烈推薦；證據(jù)等級：B）
3.Clinicians should inform patients undergoing radical prostatectomy that incontinence is expected in the short-term and generally improves to near baseline by 12 months after surgery but may persist and require treatment. (Strong Recommendation; Evidence Level: Grade A)
3. 應(yīng)向接受根治性前列腺切除術(shù)的患者告知尿失禁會在術(shù)后短期存在，通常在12個月內(nèi)改善至基線水平，但也可能持續(xù)存在并需要治療。（強烈推薦；證據(jù)強度：A）
4.Prior to radical prostatectomy, patients may be offered pelvic floor muscle exercises or pelvic floor muscle training. (Conditional Recommendation; Evidence Level: Grade C)
4. 在接受根治性前列腺切除術(shù)前，患者應(yīng)進行盆底肌鍛煉。（有條件推薦；證據(jù)等級：C）
5.Patients undergoing transurethral resection of the prostate after radiation therapy or radical prostatectomy after radiation therapy should be informed of the high rate of urinary incontinence following these procedures. (Moderate Recommendation; Evidence Level: Grade C)
5.應(yīng)向患者告知在放療后接受經(jīng)尿道前列腺切除術(shù)或根治性前列腺切除術(shù)，術(shù)后尿失禁的發(fā)生率高。（中等推薦；證據(jù)等級：C）
Post-Prostate Treatment
治療后事項
6.In patients who have undergone radical prostatectomy, clinicians should offer pelvic floor muscle exercises or pelvic floor muscle training in the immediate post-operative period. (Moderate Recommendation; Evidence Level: Grade B)
6. 應(yīng)在根治性前列腺切除術(shù)后即刻指導患者進行盆底肌鍛煉。（中等推薦；證據(jù)等級：B）
7.In patients with bothersome stress urinary incontinence after prostate treatment, surgery may be considered as early as six months if incontinence is not improving despite conservative therapy. (Conditional Recommendation; Evidence Level: Grade C)
7. 對于嚴重的前列腺治療后壓力性尿失禁患者，在保守治療6個月無效后，應(yīng)考慮手術(shù)治療。（有條件推薦；證據(jù)等級：C）
8.In patients with bothersome stress urinary incontinence after prostate treatment, despite conservative therapy, surgical treatment should be offered at one year post-prostate treatment. (Strong Recommendation; Evidence Level: Grade B)
8. 對于嚴重的前列腺治療后壓力性尿失禁患者，即使接受了保守治療，也應(yīng)在前列腺治療后1年進行手術(shù)治療。（強烈推薦；證據(jù)等級：B）
Evaluation of Incontinence after Prostate Treatment
前列腺治療后尿失禁的評估
9.Clinicians should evaluate patients with incontinence after prostate treatment with history, physical exam, and appropriate diagnostic modalities to categorize type and severity of incontinence and degree of bother. (Clinical Principle)
9. 應(yīng)根據(jù)病史、體格檢查、適當?shù)脑\斷方法對前列腺治療后尿失禁患者進行評估，以便對尿失禁的類型及嚴重程度進行分類。（臨床原則）
10.Patients with urgency urinary incontinence or urgency predominant mixed urinary incontinence should be offered treatment options per the American Urological Association Overactive Bladder guideline. (Clinical Principle)
10. 對于急迫性尿失禁或以尿急為主的混合性尿失禁患者，應(yīng)根據(jù)美國泌尿外科學會膀胱過度活動癥指南制定治療方案。（臨床原則）
11.Prior to surgical intervention for stress urinary incontinence, stress urinary incontinence should be confirmed by history, physical exam, or ancillary testing. (Clinical Principle)
11. 應(yīng)根據(jù)病史、體格檢查、輔助檢查確診壓力性尿失禁后，方行手術(shù)干預(yù)。（臨床原則）
12.Patients with incontinence after prostate treatment should be informed of management options for their incontinence, including surgical and non-surgical options. (Clinical Principle)
12. 應(yīng)向前列腺治療后尿失禁患者告知治療尿失禁的手術(shù)及非手術(shù)方案。（臨床原則）
13.In patients with incontinence after prostate treatment, physicians should discuss risk, benefits, and expectations of different treatments using the shared decision-making model. (Clinical Principle)
13. 對于前列腺治療后尿失禁患者，應(yīng)采用共同決策模式對不同治療方案的風險、獲益及預(yù)期進行討論。（臨床原則）
14.Prior to surgical intervention for stress urinary incontinence, cystourethroscopy should be per formed to assess for urethral and bladder pathology that may affect outcomes of surgery. (Expert Opinion)
14. 由于尿道及膀胱的病理狀態(tài)會對治療效果產(chǎn)生影響，故在對壓力性尿失禁手術(shù)干預(yù)前，應(yīng)行膀胱尿道鏡檢查以評估病情。（專家意見）
15.Clinicians may perform urodynamic testing in a patient prior to surgical intervention for stress urinary incontinence in cases where it may facilitate diagnosis or counseling. (Conditional Recommendation; Evidence Level: Grade C)
15. 為利于診斷及商議，應(yīng)對壓力性尿失禁患者在手術(shù)干預(yù)前行尿動力學檢查。（有條件推薦；證據(jù)等級：C）
Treatment Options
治療方法
16.In patients seeking treatment for incontinence after radical prostatectomy, pelvic floor muscle exercises or pelvic floor muscle training should be offered. (Moderate Recommendation; Evidence Level: Grade B)
16. 對于根治性前列腺切除術(shù)后尋求治療尿失禁的患者，應(yīng)進行盆底肌鍛煉。（中等推薦；證據(jù)等級：B）
17.Artificial urinary sphincter should be considered for patients with bothersome stress urinary incontinence after prostate treatment. (Strong Recommendation; Evidence Level: Grade B)
17. 對于前列腺治療后嚴重的壓力性尿失禁患者，應(yīng)考慮使用人工尿道括約肌。（強烈推薦；證據(jù)等級：B）
18.Prior to implantation of artificial urinary sphincter, clinicians should ensure that patients have adequate physical and cognitive abilities to operate the device. (Clinical Principle)
18. 在接受人工尿道括約肌植入術(shù)前，應(yīng)確認患者有足夠的身體條件及認知能力操縱該裝置。（臨床原則）
19.In the patient who selects artificial urinary sphincter, a single cuff perineal approach is preferred. (Moderate Recommendation; Evidence Level: Grade C)
19. 對選擇使用人工尿道括約肌的患者，推薦采用經(jīng)會陰單袖套法。（中等推薦；證據(jù)等級：C）
20.Male slings should be considered as treatment options for mild to moderate stress urinary incontinence after prostate treatment. (Moderate Recommendation; Evidence Level: Grade B)
20. 男性吊帶應(yīng)作為前列腺治療后輕度至中度壓力性尿失禁的治療方法。（中等推薦；證據(jù)等級：B）
21.Male slings should not be routinely performed in patients with severe stress incontinence. (Moderate Recommendation; Evidence Level: Grade C)
21. 男性吊帶不應(yīng)常規(guī)應(yīng)用在重度壓力性尿失禁患者。（中等推薦；證據(jù)等級：C）
22.Adjustable balloon devices may be offered to patients with mild stress urinary incontinence after prostate treatment. (Moderate Recommendation; Evidence Level: Grade B)
22. 可調(diào)節(jié)球囊裝置可應(yīng)用在前列腺治療后輕度壓力性尿失禁患者。（中等推薦；證據(jù)等級：B）
23.Surgical management of stress urinary incontinence after treatment of benign prostatic hyperplasia is the same as that for patients after radical prostatectomy. (Moderate Recommendation; Evidence Level: Grade C)
23. 良性前列腺增生術(shù)后壓力性尿失禁的手術(shù)治療方案，與根治性前列腺切除術(shù)后的一致。（中等推薦；證據(jù)等級：C）
24.In men with stress urinary incontinence after primary, adjuvant, or salvage radiotherapy who are seeking surgical management, artificial urinary sphincter is preferred over male slings or adjustable balloons. (Moderate Recommendation; Evidence Level: Grade C)
24. 在初始、輔助或挽救放療后尋求手術(shù)治療壓力性尿失禁的患者中，人工尿道括約肌優(yōu)于男性吊帶及可調(diào)節(jié)球囊裝置。（中等推薦；證據(jù)等級：C）
25.Patients with incontinence after prostate treatment should be counseled that efficacy is low and cure is rare with urethral bulking agents. (Strong Recommendation; Evidence Level: Grade B)
25. 應(yīng)告知前列腺治療后尿失禁患者，尿道周圍填充術(shù)的效果有限、治愈率低。（強烈推薦；證據(jù)等級：B）
26.Other potential treatments for incontinence after prostate treatment should be considered investigational, and patients should be counseled accordingly. (Expert Opinion)
26. 前列腺治療后尿失禁的其他潛在治療方法尚處于研究階段，應(yīng)向患者進行相關(guān)告知。（專家意見）
Complications after Surgery
術(shù)后并發(fā)癥
27.Patients should be counseled that artificial urinary sphincter will likely lose effectiveness over time, and reoperations are common. (Strong Recommendation; Evidence Level: Grade B)
27. 應(yīng)告知患者隨著時間推移人工尿道括約肌可能會失效，并且再次手術(shù)常見。（強烈推薦；證據(jù)等級：B）
28.In patients with persistent or recurrent urinary incontinence after artificial urinary sphincter or sling, clinicians should again perform history, physical examination, and/or other investigations to determine the cause of incontinence. (Clinical Principle)
28. 對于人工尿道括約肌植入術(shù)后或尿道懸吊術(shù)后持續(xù)性或復發(fā)的尿失禁患者，應(yīng)再次通過病史、體格檢查和（或）其他方法明確尿失禁原因。（臨床原則）
29.In patients with persistent or recurrent stress urinary incontinence after sling, an artificial urinary sphincter is recommended. (Moderate Recommendation; Evidence Level: Grade C)
29. 對于尿道懸吊術(shù)后持續(xù)性或復發(fā)的壓力性尿失禁患者，建議行人工尿道括約肌植入術(shù)。（中等推薦；證據(jù)等級：C）
30.In patients with persistent or recurrent stress urinary incontinence after artificial urinary sphincter, revision should be considered. (Strong Recommendation; Evidence Level: Grade B)
30. 對于人工尿道括約肌植入術(shù)后持續(xù)性或復發(fā)的壓力性尿失禁患者，建議修訂治療方案。（強烈推薦；證據(jù)等級：B）
Special Situations
特殊情況
31.In a patient presenting with infection or erosion of an artificial urinary sphincter or sling, explantation should be performed and reimplantation should be delayed. (Clinical Principle)
31. 當人工尿道括約肌或吊帶出現(xiàn)感染或侵蝕時，應(yīng)取出植入物，再次植入應(yīng)延期進行。（臨床原則）
32.A urinary diversion can be considered in patients who are unable to obtain long-term quality of life after incontinence after prostate treatment and who are appropriately motivated and counseled. (Expert Opinion)
32. 若前列腺治療后尿失禁患者的生活質(zhì)量無法長期獲益，建議行尿流改道術(shù)。（專家意見）
33.In a patient with bothersome climacturia, treatment may be offered. (Conditional Recommendation; Evidence Level: Grade C)
33. 對于嚴重的性高潮期遺尿患者，應(yīng)進行治療。（有條件推薦；證據(jù)等級：C）
34.Patients with stress urinary incontinence following urethral reconstructive surgery may be offered artificial urinary sphincter and should be counseled that complications rates are higher. (Conditional Recommendation; Evidence Level: Grade C)
34. 對于尿道重建術(shù)后壓力性尿失禁患者，可行人工尿道括約肌植入術(shù)，應(yīng)告知并發(fā)癥發(fā)生率更高。（有條件推薦；證據(jù)等級：C）
35.In patients with incontinence after prostate treatment and erectile dysfunction, a concomitant or staged procedure may be offered. (Conditional Recommendation; Evidence Level: Grade C)
35. 對于合并勃起功能障礙的前列腺治療后尿失禁患者，可行同期或分期手術(shù)。（有條件推薦；證據(jù)等級：C）
36.Patients with symptomatic vesicourethral anastomotic stenosis or bladder neck contracture should be treated prior to surgery for incontinence after prostate treatment. (Clinical Principle)
36. 對于合并有癥狀的膀胱尿道吻合口狹窄或膀胱頸攣縮患者，應(yīng)在手術(shù)治療尿失禁前，先處理狹窄或攣縮。（臨床原則）
