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Urinary incontinence after radical prostatectomy: implications and urodynamics.
T J McCallum1, K N Moore, D Griffiths
1Boston University School of Medicine, Boston, MA, USA.
Urologic Nursing
|May 10, 2002
Summary
Men with post-prostatectomy urinary incontinence experience reduced quality of life but adapt. Urodynamic testing reveals detrusor dysfunction is a common cause, not just stress incontinence.
Area of Science:
- Urology
- Men's Health
- Post-Surgical Outcomes
Background:
- Radical prostatectomy can lead to persistent urinary incontinence in some men.
- Evaluating long-term outcomes is crucial for understanding patient quality of life and treatment needs.
Purpose of the Study:
- To assess urine loss, quality of life, and urodynamic findings in men with post-radical prostatectomy urinary incontinence.
- To investigate the underlying causes of incontinence at least 12 months after surgery.
Main Methods:
- A cohort of 16 men with persistent incontinence (≥2 years post-surgery) from a prior study were evaluated.
- Methods included a 24-hour pad test, frequency/volume chart, quality-of-life questionnaire, and video urodynamics.
Main Results:
- Mean 24-hour urine loss was 164g, significantly impacting quality of life.
- Most men would repeat the radical prostatectomy despite incontinence.
- Half of patients with stress urinary incontinence also showed detrusor dysfunction (urge incontinence/decreased compliance).
Conclusions:
- Urinary incontinence after radical prostatectomy substantially affects quality of life, though most patients adapt and would still opt for the surgery.
- Urodynamic evaluation is essential as stress incontinence symptoms may not fully represent the diagnosis; detrusor dysfunction is a key consideration.