[Can preoperative urodynamic examination allow us to predict the risk of incontinence after radical prostatectomy?]

To verify whether bladder dysfunction detected by urodynamic studies prior to radical prostatectomy can predict postoperative continence status.

Twenty patients diagnosed with prostate cancer had multichannel subtracted filling and voiding videocystometry before undergoing radical retropubic prostatectomy. Postoperatively, all patients had periodic clinical assessment of continence status.

On preoperative filling cystometry, detrusor instability with a maximal detrusor pressure greater than 15 cm H2O was demonstrated in 12/20 patients (60%). Postoperatively, 11/20 patients (55%) were continent, 4 (20%) had mild stress incontinence and 5 (25%) complained of episodic urge incontinence. However, only 5 of the 12 patients with preoperatively diagnosed detrusor instability manifested clinical urge incontinence after surgery (positive predictive value = 41.6%).

The incidence of preoperative detrusor instability in our series was high, but little correlation was found between this finding and postoperative incontinence.