title: Can low urinary tract symptoms influence postprostatectomy urinary incontinence?
abstract: BACKGROUND
  The aim of this study was to analyze what kind of urinary symptoms patients have before receiving treatment by radical prostatectomy (RP), and to evaluate their influence on urinary incontinence (UI).
  
  
  METHODS
  Between 2002 and 2012, 758 consecutive patients underwent RP for clinically localized prostate cancer (PCa). Surgery was carried out by open retropubic RP in 545 (73.1%) of patients and laparoscopic RP in 201 (27%) by 5 surgeons who were excluded from data collection and analysis. The following symptoms were collected from the last urological check-ups or pre-operative consultation and classified as: storage symptoms, voiding symptoms, post micturition symptoms, history of acute urinary retention, benign prostatic hyperplasia treatment, history of transurethral resection of the prostate (TURP).
  
  
  RESULTS
  A total of 661 patients were included on analysis: 136 (20.6%) patients reported low urinary tract symptoms (LUTS), 162 (24.5%) were considered incontinent after RP, and 45 (33.1%) of them reported LUTS before surgery. Postprostatectomy urinary incontinence (PPUI) was significantly different in patients with LUTS (117 [22.3%] vs. 45 [33.1%], P=0.009). The presence of any LUTS influence significantly in the appearance of PPUI (OR=1.72 [95% CI: 1.14-2.6), P=0.01). TURP is independently influential in PPUI (OR=6.13 [95% CI: 1.86-20.18], P=0.003). A patient with LUTS before surgery has an increased risk of 70% or even 200% to suffer PPUI and a patient who received treatment by TURP is 6 times at higher risk of PPUI.
  
  
  CONCLUSIONS
  In conclusion, patients with LUTS are likely to present PPUI. History of TURP is influential by itself over PPUI. A good preoperative consultation is important to assess continence status and to create realistic expectations to patients before RP.
authors.affiliation: Department of Urology, University Hospital of Navarre, Pamplona, Spain - atienza@unav.es.
authors.forename: Antonio
authors.initials: A
authors.lastname: Tienza
authors.forename: Mateo
authors.initials: M
authors.lastname: Hevia
authors.forename: Imanol
authors.initials: I
authors.lastname: Merino
authors.forename: Fernando
authors.initials: F
authors.lastname: Diez-Caballero
authors.forename: David
authors.initials: D
authors.lastname: Rosell
authors.forename: Juan I
authors.initials: JI
authors.lastname: Pascual
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Zudaire
authors.forename: José E
authors.initials: JE
authors.lastname: Robles
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology*; D011471:Prostatic Neoplasms / Q000601:surgery; D020728:Transurethral Resection of Prostate / Q000009:adverse effects*; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000209:etiology*