Standing cough test for evaluation of post-prostatectomy incontinence: a pilot study

Area of Science:

• Urology
• Andrology
• Surgical Assessment

Background:

• Post-prostatectomy incontinence (PPI) is a common complication.
• Objective assessment tools are needed to guide surgical intervention for male stress urinary incontinence (SUI).

Purpose of the Study:

• To implement and evaluate a standardized Standing Cough Test (SCT) for assessing men with PPI.
• To stratify PPI severity using the Male Stress Incontinence Grading Scale (MSIGS) to facilitate surgical procedure selection.

Main Methods:

• The SCT was performed during initial consultations for PPI.
• Patients were graded 0-4 using the MSIGS.
• Mild SUI (grades 0-2) patients were offered sling surgery; moderate-severe SUI (grades 3-4) patients were offered artificial urinary sphincter (AUS).
• MSIGS grade was correlated with preoperative pads per day (PPD).

Main Results:

• 62 PPI patients were assessed; 32% had mild SUI, 68% had moderate-severe SUI.
• MSIGS grade strongly correlated with preoperative PPD (r=0.74).
• 53 patients underwent surgery: 14 received slings, 39 received AUS.
• High patient-reported improvement (median 95%) was observed in both groups.

Conclusions:

• Men with chronic PPI often present late for treatment.
• The SCT provides objective, immediate PPI severity data.
• SCT correlates with PPD and can expedite surgical selection for male anti-incontinence procedures.