title: Risk factors for urinary incontinence after radical prostatectomy.
abstract: OBJECTIVE
  We identified risk factors associated with urinary incontinence after radical retropubic prostatectomy.
  
  
  METHODS
  The time from operation until urinary continence was achieved was determined by chart review and questionnaire in 581 patients who were continent before undergoing radical retropubic prostatectomy between 1983 and 1994. Using univariate and multivariate analyses of data gathered prospectively, we examined risk factors associated with incontinence in these patients.
  
  
  RESULTS
  The actuarial rate of urinary continence at 24 months was 91% for the entire patient population and 95% for those treated after 1990. Many factors were associated with the risk of incontinence in univariate Cox proportional hazards regression analysis (patient age and weight, degree of obstructive voiding symptoms, prior transurethral resection of the prostate, clinical stage, intraoperative blood loss, resection of neurovascular bundles, postoperative anastomotic stricture and technique of vesicourethral anastomosis). However, in a multivariate analysis the factors that were independently associated with increased chance of regaining continence were decreasing age, a modification in the technique of anastomosis (introduced in 1990), preservation of both neurovascular bundles and absence of an anastomotic stricture. With introduction of the new surgical technique in 1990 the median time to continence decreased from 5.6 to 1.5 months and the rate of continence at 24 months increased from 82 to 95%.
  
  
  CONCLUSIONS
  While the risk of urinary incontinence after radical prostatectomy is related to the uncontrollable factor of patient age, it is also sensitive to the surgical technique used.
authors.affiliation: Matsunaga-Conte Prostate Cancer Research Center, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Eastham
authors.forename: M W
authors.initials: MW
authors.lastname: Kattan
authors.forename: E
authors.initials: E
authors.lastname: Rogers
authors.forename: J R
authors.initials: JR
authors.lastname: Goad
authors.forename: M
authors.initials: M
authors.lastname: Ohori
authors.forename: T B
authors.initials: TB
authors.lastname: Boone
authors.forename: P T
authors.initials: PT
authors.lastname: Scardino
mesh_terms: D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods*; D012307:Risk Factors; D013536:Suture Techniques; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000209:etiology