Urinary incontinence following prostatectomy in patients with myasthenia gravis

An unusual incidence of urinary incontinence was observed in patients with myasthenia gravis who required transurethral resection of the prostate for relief of obstruction secondary to benign prostatic hypertrophy. This urinary incontinence was not observed in patients who had open prostatectomies (suprapubic and retropubic). The urinary incontinence did not appear to be related to the control of the underlying muscular disorder. It is suggested that the external sphincter in patients with myasthenia gravis may be more vulnerable to thermal changes that occur when a blended current is used during transurethral resection. If prostatectomy is required in a patient with myasthenia gravis, open surgery should be the procedure of choice. If a TURP is used, then a high frequency current is advised with prudent resection in the area of the prostatic apex.