Recent data upon impotence, incontinence and quality of life issues concerning radical prostatectomy

To present recent data dealing with the two major post-radical prostatectomy complications incontinence and sexual dysfunction, and investigate if they affect the quality of life of the patients.

We evaluated recent data available on Medline, from different series examining the incidence, pathophysiology, evaluation and treatment of incontinence and impotence after radical prostatectomy. We also evaluated the effect upon quality of life of these complications.

Many experienced surgeons observe low incidence rates of incontinence and sexual dysfunction after radical prostatectomy and it seems that meticulous surgical technique might prevent these devastating complications. However, there are many papers in the literature, which show a great variety of results with incontinence ranging from to 0.3 to 65.6% and potency rates from 11.6 to 86% among treated patients. Depending on the individual's opinion incontinence is a minor problem and does not have a great impact upon their quality of life. Impotence affects more frequently these men and seems to be the most disturbing complication after radical prostatectomy affecting the quality of life.

Today avoidance of major complications after radical prostatectomy depends mostly upon high quality surgical technique. Post-radical prostatectomy incontinence does not seem to be a frequent event and when it occurs it does not dramatically affect patients' quality of life. Impotence although most annoying for the majority of the treated patients can be effectively managed by various methods when the neurovascular bundles are preserved.