Concurrent assessment of obstructive/irritative urinary symptoms and incontinence after radical prostatectomy

To concurrently evaluate urinary obstructive symptoms and incontinence in men after radical prostatectomy and to determine the effects of these components on urinary impairment and satisfaction.

Two hundred twenty-eight men after radical prostatectomy were age-matched and zip code-matched to a random sample of 228 men without prostate cancer. Urinary incontinence was assessed by the urinary function domain of the Prostate Cancer Index, and obstructive symptoms were assessed by the American Urological Association Symptom Index. Regression models were constructed to evaluate the impact of obstructive and incontinence symptoms on urinary impairment and satisfaction.

The control group reported greater urinary continence (P <0.0001) and less impairment (P <0.0001) than the prostatectomy group, but a difference was not observed for obstructive symptoms. Obstructive urinary symptoms were associated with impairment for both the prostatectomy and the control groups (P <0.0001), and incontinence symptoms were more strongly associated with impairment in the prostatectomy group than in the control group (P = 0.01). Greater obstructive/irritative and incontinence symptoms were associated with lower satisfaction (P <0.0001).

Urinary incontinence was more common in the radical prostatectomy group, but differences were not seen for obstructive symptoms. In addition to incontinence symptoms, obstructive symptoms were associated with urinary impairment and dissatisfaction in the prostatectomy group, suggesting that these symptoms should also be assessed after radical prostatectomy.