[Radical prostatectomy complications: evolution and conservative management of urinary incontinence].
OBJECTIVE
Radical retropubic prostatectomy is the major procedure for curing early stage prostate cancer. In this retrospective study we valued the complications of this surgery and its evolution in time, as well as the efectiveness of the urinary incontinence preservative treatment in the recovery of urinary continence.


METHODS
During the period between december of 1998 to january of the 2005 we have treated 168 patients suffering prostatic adenocarcinoma clinically confined to the gland by means of retropubic radical prostatectomy. We removed the vesical catheter the fourteenth day of the postoperative and made a clinical monitoring the first, third and sixth month after the surgery, and thereafter every six months.


RESULTS
Of the 168 patients who underwent clinical surgery, 15% required postoperative blood transfusion in the immediate postoperative. Other complications, with a lower incidence, were the intestinal perforation, surgical wound infection and the haematoma. The most frequent delayed complications we registered were erectile dysfunction, observed in 164 patients (98%), micturition alterations in 32 patients (19%) and intestinal alterations in approximately 11%. Among the micturitional alterations found, the most frequent (64%) was the Urinary Incontinence (UI). However, most of them were of minor importance (34%) and all improved during the first six months after the surgery. We advised patients with minor and moderate UI to perform pelvic floor muscle training, being very useful since they allowed to anticipate the recovery of continence.


CONCLUSIONS
Radical prostatectomy continues to be the most effective treatment for the non spared prostate cancer, in spite of the associated morbidity. The IU is the main factor for the high standard of living these patients. Despite the number of patients with UI being so high, most cases are moderate and minor and may improve with pelvic floor muscle training. Hence, this is a significant tool to tackle this illness, whether in connection with the use of absorbent, the pharmacologic therapy or the use of penile collectors.
Juan Escudero
J U
JU
Servicio de Urología, Consorcio Hospital General Universitario de Valencia, Valencia. chimojuan@hotmail.com
Ramos de Campos
M
M
Ordoño Domínguez
F
F
Fabuel Deltoro
M
M
Navalón Verdejo
P
P
Zaragoza Orts
J
J
D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D005081:Exercise Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000601:surgery*; D014549:Urinary Incontinence / Q000209:etiology* / Q000628:therapy*