[Incontinence following prostatectomy]

Urinary continence is guaranteed by many factors. The most important are an intact bladderneck and a normally operating proximal urethra. Predominantly the smooth muscular system is involved. The striated external sphincter is primarily not responsible for continence. At prostatectomy the bladderneck and a great part of the smooth muscles of the proximal urethra inevitably are removed. Postoperatively only a small distal segment of the posterior urethra continues to guarantee continence. This segment may be changed by the growth of the prostate and can be destroyed by an untrained operator. Then, urinary incontinence is the result.