title: Urinary incontinence and voiding dysfunction after radical retropubic prostatectomy (prospective urodynamic study).
abstract: OBJECTIVE
  During this prospective study we analyzed the effects of radical retropubic prostatectomy (RRP) on bladder and sphincter function by comparing preoperative and postoperative urodynamic data. The aim of the study was to determine the reason for urinary incontinence after RRP and explain why one group of patients will be immediately continent after catheter removal, while others need some time to reach complete continence.
  
  
  METHODS
  Urodynamic examination was performed in 63 patients 3-7 days before and 2 months after surgery.
  
  
  RESULTS
  Forty-three (68.2%) and 53 (84.1%) patients regained continence at 2 and 9 months following RRP, respectively. Ten patients (15.9%) were immediately continent after catheter removal. Urodynamic stress incontinence was detected in 18 (28.6%), and detrusor overactivity incontinence in 2 (3.2%) patients 2 months after surgery. The amplitude of preoperative maximal voluntary sphincteric contractions was significantly higher in the postoperative continent group (125 vs. 96.5 cmH(2)O, P < 0.0001). The patients who were immediately continent following catheter removal had no lower urinary tract symptoms (LUTS) and urodynamic abnormality preoperatively, and they had significantly higher preoperative and postoperative maximum urethral closure pressure (at rest and during voluntary sphincter contraction) than those who became continent later on.
  
  
  CONCLUSIONS
  These data suggest that the main cause of incontinence after RRP is sphincteric weakness. In the continent group, those who became immediately continent had significantly higher maximum urethral closure pressure values at rest and at voluntary sphincteric contraction even before the surgery.
authors.affiliation: Department of Urology, Semmelweis Medical University, Budapest, Hungary. majorosat@web.de
authors.forename: Attila
authors.initials: A
authors.lastname: Majoros
authors.forename: Dietmar
authors.initials: D
authors.lastname: Bach
authors.forename: Attila
authors.initials: A
authors.lastname: Keszthelyi
authors.forename: Antal
authors.initials: A
authors.lastname: Hamvas
authors.forename: Imre
authors.initials: I
authors.lastname: Romics
mesh_terms: D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology*; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery; D014549:Urinary Incontinence / Q000209:etiology*; D014555:Urination Disorders / Q000209:etiology*; D014563:Urodynamics / Q000502:physiology*