The evaluation of 68 patients with post-prostatectomy incontinence

Sixty-eight patients with incontinence following prostatectomy for benign prostatic hypertrophy were studied. Detrusor instability was present in 45 patients, most commonly associated with sphincter damage (28 patients), but alone in 11, and with residual obstruction in 6 patients. Sphincter damage was the cause of incontinence in 47 patients (alone in 18, with detrusor instability in 28, and with residual obstruction in 3). Some patients who complained of a combination of frequency, nocturia and urgency before prostatectomy were later found to have detrusor instability, but post-operatively no association between symptoms and pathology was noted. It is suggested that the need for surgery should be definitely established in patients who present with equivocal symptoms. All patients with a combination of frequency, nocturia and urgency should have a urodynamic assessment before prostatectomy.