Artificial urinary sphincters are offered for moderate-to-severe urinary incontinence in males and have shown good long-term efficacy and safety. The use of artificial urinary sphincters for post-prostatectomy incontinence is supported by the recommendations of European Association of Urology and International Consultation on Incontinence. Transurethral injection of bulking agents have little role in the management of post-prostatectomy incontinence and there is weak evidence that these agents can offer any improvement. Pelvic floor muscle training can speed recovery of urinary incontinence following prostatectomy. Remedies to post-operative sexual dysfunction Very few surgeons will claim that patients return to the erectile experience they had prior to surgery. The rates of erectile recovery that surgeons often cite are qualified by the addition of sildenafil to the recovery regimen. Remedies to the problem of post-operative sexual dysfunction include: Medications Intraurethral suppositories Penile injections Vacuum devices Penile implants Epidemiology The use of radical prostatectomy as treatment for prostate cancer increased significantly from 1980 to 1990. As of 2000, the median age of men undergoing radical prostatectomy for localized prostate cancer was 62. Though a very common procedure, the experience level of the surgeon performing the operation is important in determining the outcomes, rate of complications, and side effects. The more prostatectomies performed by a surgeon, the better the outcomes. This is true for prostatectomies done as open procedures and those done using minimally invasive techniques. History William Belfield, MD is generally credited for performing the first intentional prostatectomy via the suprapubic route in 1885, 1886 or 1887 at Cook County Hospital in Chicago. Hugh H. Young MD in collaboration with William Stewart Halsted MD developed the open, radical and perineal prostatectomies in 1904 at Johns Hopkins Brady Urological Institute, the first version of the procedure that became generally feasible. The Irish surgeon Terence Millin, MD (1903–1980) developed the radical retropubic prostatectomy in 1945. American urologist Patrick C. Walsh, MD (1938—present) developed the modern nerve-sparing, retropubic prostatectomy with minimal blood loss. The first laparoscopic prostatectomy was performed in 1991 by William Schuessler, MD and colleagues in Texas. Costs A 2014 survey of prostatectomy fees for uninsured patients at 70 United States hospitals found an average facility fee of $34,720 and average surgeon and anesthesiologist fees of $8,280. See also List of surgeries by type References External links The Basics of the Prostatectomy Procedure Explained Prostatectomy – slideshow by The New York Times Surgical oncology Surgical removal procedures Male