title: Urinary incontinence and neuropathy after radical prostatectomy: diagnosis and treatment.
abstract: OBJECTIVE
  The urinary incontinence after radical prostatectomy is secondary to neuropathy with various degrees from neurapraxia to neurotmesis. We propose to apply therapeutic and rehabilitative models appropriate to the diagnosis and to evaluate the results.
  
  
  METHODS
  We examined 79 homogeneous patients with urinary incontinence after radical prostatectomy. After having defined the diagnosis by a urodynamic examination, the study of pudendal nerve somatosensory-evoked potentials (SEPs) and perineal electromyography (EMG), patients were divided into four groups (A; B; C; D) and submitted to different clinical drug protocols and rehabilitation. After 3 months, patients were reevaluated.
  
  
  RESULTS
  Twenty-eight patients with idiopathic overactive bladder (Group A) have been treated with anticholinergics: two unchanged (7%); 14 improved (50%); and 12 recovered (43%). Sixteen patients with overactive bladder and sphincter incompetence (Group B) have practiced physiokinesis therapy (FKT) of pelvic floor and anticholinergic therapy: one unchanged (6%); eight improved (50%); and seven recovered (44%). Fourteen patients with perineal incompetence to continence (Group C) have been treated with FES, FKT of pelvic floor, and Biofeedback: three patients were unchanged (21%); five improved (36%); and six recovered (43%). Twenty-one patients with sphincter denervation (Group D) performed FES, FKT of pelvic floor, and Biofeedback: 16 unchanged (76%); five improved (24%); and zero recovered (0%). Of these 16 patients, six non-responders have placed a transobturator tape (TOT) sling and four an artificial sphincter.
  
  
  CONCLUSIONS
  A therapy adherent to the diagnosis increases success rate.
authors.affiliation: Department of Surgery, Urology Clinic, Neurourology and Urodynamics, University of Catania, Catania - Italy.
authors.forename: Bernardo
authors.initials: B
authors.lastname: Ventimiglia
authors.forename: Matilde
authors.initials: M
authors.lastname: Sigona
authors.forename: Agata
authors.initials: A
authors.lastname: Di Dio
authors.forename: Tiziana
authors.initials: T
authors.lastname: Puglisi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Costantino
mesh_terms: D000368:Aged; D001676:Biofeedback, Psychology / Q000379:methods; D004576:Electromyography; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects*; D012189:Retrospective Studies; D053825:Suburethral Slings; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D014549:Urinary Incontinence / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D014563:Urodynamics