[Urodynamics of urinary incontinence post radical prostatectomy]. 1998

J Salinas Casado, and M Virseda Chamorro, and H Fernández Ajubita, and J C Ramírez Fernández, and I Fuentes Márquez, and L Resel Estévez
Servicio de Urología, Hospital Universitario San Carlos, Universidad Complutense, Madrid, España.

OBJECTIVE To determine the urodynamic characteristics of urinary incontinence after radical retropubic prostatectomy. METHODS We conducted a clinical and urodynamic study on 25 patients who had undergone radical retropubic prostatectomy due to localized prostate adenocarcinoma. RESULTS 68% of the patients completely recovered urinary continence. The maximum rate of urinary continence recovery was found between the third and fourth month postprostatectomy. A relationship was demonstrated between preoperative hormone blockade, duration of the surgery and urinary continence. Videocystography demonstrated an incompetent proximal continence mechanism in all radical prostatectomy patients. All incontinent patients presented stress urinary incontinence. Denervation potentials of the periurethral sphincter was demonstrated by electromyography in 80% of incontinent patients. These potentials were not present in the continent patients. Reinnervation potentials were present in 50% of the continent patients and in 20% of the incontinent patients (significant differences). No relationship was found between other urodynamic data and post-radical prostatectomy urinary incontinence. CONCLUSIONS The surgical difficulty influences the preservation of urinary continence. A high percentage of patients submitted to radical prostatectomy recover urinary continence with time. Urinary incontinence following radical prostatectomy is based on the distal sphincteric mechanism. Patients who remain incontinent four months postoperatively and with electromyographically demonstrated denervation potentials of the periurethral sphincter can be considered to be candidates for treatment of incontinence without waiting any further.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D011468 Prostatectomy Complete or partial surgical removal of the prostate. Three primary approaches are commonly employed: suprapubic - removal through an incision above the pubis and through the urinary bladder; retropubic - as for suprapubic but without entering the urinary bladder; and transurethral (TRANSURETHRAL RESECTION OF PROSTATE). Prostatectomy, Retropubic,Prostatectomy, Suprapubic,Prostatectomies,Prostatectomies, Retropubic,Prostatectomies, Suprapubic,Retropubic Prostatectomies,Retropubic Prostatectomy,Suprapubic Prostatectomies,Suprapubic Prostatectomy
D004576 Electromyography Recording of the changes in electric potential of muscle by means of surface or needle electrodes. Electromyogram,Surface Electromyography,Electromyograms,Electromyographies,Electromyographies, Surface,Electromyography, Surface,Surface Electromyographies
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D014549 Urinary Incontinence Involuntary loss of URINE, such as leaking of urine. It is a symptom of various underlying pathological processes. Major types of incontinence include URINARY URGE INCONTINENCE and URINARY STRESS INCONTINENCE. Incontinence, Urinary
D014563 Urodynamics The mechanical laws of fluid dynamics as they apply to urine transport. Urodynamic
D015331 Cohort Studies Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics. Birth Cohort Studies,Birth Cohort Study,Closed Cohort Studies,Cohort Analysis,Concurrent Studies,Historical Cohort Studies,Incidence Studies,Analysis, Cohort,Cohort Studies, Closed,Cohort Studies, Historical,Studies, Closed Cohort,Studies, Concurrent,Studies, Historical Cohort,Analyses, Cohort,Closed Cohort Study,Cohort Analyses,Cohort Studies, Birth,Cohort Study,Cohort Study, Birth,Cohort Study, Closed,Cohort Study, Historical,Concurrent Study,Historical Cohort Study,Incidence Study,Studies, Birth Cohort,Studies, Cohort,Studies, Incidence,Study, Birth Cohort,Study, Closed Cohort,Study, Cohort,Study, Concurrent,Study, Historical Cohort,Study, Incidence

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