Literature DB >> 16224797

Urinary incontinence and voiding dysfunction after radical retropubic prostatectomy (prospective urodynamic study).

Attila Majoros1, Dietmar Bach, Attila Keszthelyi, Antal Hamvas, Imre Romics.   

Abstract

AIMS: During this prospective study we analyzed the effects of radical retropubic prostatectomy (RRP) on bladder and sphincter function by comparing preoperative and postoperative urodynamic data. The aim of the study was to determine the reason for urinary incontinence after RRP and explain why one group of patients will be immediately continent after catheter removal, while others need some time to reach complete continence.
METHODS: Urodynamic examination was performed in 63 patients 3-7 days before and 2 months after surgery.
RESULTS: Forty-three (68.2%) and 53 (84.1%) patients regained continence at 2 and 9 months following RRP, respectively. Ten patients (15.9%) were immediately continent after catheter removal. Urodynamic stress incontinence was detected in 18 (28.6%), and detrusor overactivity incontinence in 2 (3.2%) patients 2 months after surgery. The amplitude of preoperative maximal voluntary sphincteric contractions was significantly higher in the postoperative continent group (125 vs. 96.5 cmH(2)O, P < 0.0001). The patients who were immediately continent following catheter removal had no lower urinary tract symptoms (LUTS) and urodynamic abnormality preoperatively, and they had significantly higher preoperative and postoperative maximum urethral closure pressure (at rest and during voluntary sphincter contraction) than those who became continent later on.
CONCLUSIONS: These data suggest that the main cause of incontinence after RRP is sphincteric weakness. In the continent group, those who became immediately continent had significantly higher maximum urethral closure pressure values at rest and at voluntary sphincteric contraction even before the surgery. Neurourol. Urodynam. (c) 2005 Wiley-Liss, Inc.

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Mesh:

Year:  2006        PMID: 16224797     DOI: 10.1002/nau.20190

Source DB:  PubMed          Journal:  Neurourol Urodyn        ISSN: 0733-2467            Impact factor:   2.696


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