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Comprehensive urodynamics evaluation of 146 men with incontinence after radical prostatectomy.
Urology. 2005 Aug; 66(2):392-6.U

Abstract

OBJECTIVES

To assess the filling, storage, and voiding urodynamic parameters in a large group of men with urinary incontinence after radical prostatectomy.

METHODS

We reviewed the videourodynamics testing results for 146 consecutive men referred for urinary incontinence after radical prostatectomy.

RESULTS

The mean patient age was 69.0 years (range 48 to 85), and the mean interval since radical prostatectomy was 4 years (range 4 months to 19 years). All but four tests were performed more than 12 months postoperatively. Stress urinary incontinence (SUI) was demonstrated in 139 men (95%), with a mean abdominal leak point pressure of 59 cm H2O. A statistically significant correlation was found between the leak point pressure and static urethral pressure profilometry measurements (r = 0.46, P < 0.0001). The mean urethral pressure profilometry measurements in those with SUI were significantly lower than in those without (46.6 versus 69 cm H2O, P = 0.001). A total of 34 patients had diminished compliance or detrusor instability, but this was the sole finding in only 3. A hypocontractile detrusor response was seen in 49 patients, and 35 of these augmented voiding by abdominal straining. Patients with previous radiotherapy (n = 24) were more likely to have bladder outlet obstruction; the other parameters were similar to those in patients without radiotherapy.

CONCLUSIONS

Incontinence after radical prostatectomy is caused by intrinsic sphincter deficiency in the vast majority of patients. Urethral pressure profilometry measurements correlated with the severity of SUI, as measured by abdominal leak point pressure. Bladder outlet obstruction may coexist with SUI in a significant portion of patients. During voiding, a hypocontractile detrusor response may be seen, but the clinical significance of this finding is unclear.

Authors+Show Affiliations

Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA. skielb@nmff.orgNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16040102

Citation

Kielb, Stephanie J., and J Quentin Clemens. "Comprehensive Urodynamics Evaluation of 146 Men With Incontinence After Radical Prostatectomy." Urology, vol. 66, no. 2, 2005, pp. 392-6.
Kielb SJ, Clemens JQ. Comprehensive urodynamics evaluation of 146 men with incontinence after radical prostatectomy. Urology. 2005;66(2):392-6.
Kielb, S. J., & Clemens, J. Q. (2005). Comprehensive urodynamics evaluation of 146 men with incontinence after radical prostatectomy. Urology, 66(2), 392-6.
Kielb SJ, Clemens JQ. Comprehensive Urodynamics Evaluation of 146 Men With Incontinence After Radical Prostatectomy. Urology. 2005;66(2):392-6. PubMed PMID: 16040102.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comprehensive urodynamics evaluation of 146 men with incontinence after radical prostatectomy. AU - Kielb,Stephanie J, AU - Clemens,J Quentin, PY - 2005/01/07/received PY - 2005/02/18/revised PY - 2005/03/07/accepted PY - 2005/7/26/pubmed PY - 2005/12/13/medline PY - 2005/7/26/entrez SP - 392 EP - 6 JF - Urology JO - Urology VL - 66 IS - 2 N2 - OBJECTIVES: To assess the filling, storage, and voiding urodynamic parameters in a large group of men with urinary incontinence after radical prostatectomy. METHODS: We reviewed the videourodynamics testing results for 146 consecutive men referred for urinary incontinence after radical prostatectomy. RESULTS: The mean patient age was 69.0 years (range 48 to 85), and the mean interval since radical prostatectomy was 4 years (range 4 months to 19 years). All but four tests were performed more than 12 months postoperatively. Stress urinary incontinence (SUI) was demonstrated in 139 men (95%), with a mean abdominal leak point pressure of 59 cm H2O. A statistically significant correlation was found between the leak point pressure and static urethral pressure profilometry measurements (r = 0.46, P < 0.0001). The mean urethral pressure profilometry measurements in those with SUI were significantly lower than in those without (46.6 versus 69 cm H2O, P = 0.001). A total of 34 patients had diminished compliance or detrusor instability, but this was the sole finding in only 3. A hypocontractile detrusor response was seen in 49 patients, and 35 of these augmented voiding by abdominal straining. Patients with previous radiotherapy (n = 24) were more likely to have bladder outlet obstruction; the other parameters were similar to those in patients without radiotherapy. CONCLUSIONS: Incontinence after radical prostatectomy is caused by intrinsic sphincter deficiency in the vast majority of patients. Urethral pressure profilometry measurements correlated with the severity of SUI, as measured by abdominal leak point pressure. Bladder outlet obstruction may coexist with SUI in a significant portion of patients. During voiding, a hypocontractile detrusor response may be seen, but the clinical significance of this finding is unclear. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/16040102/Comprehensive_urodynamics_evaluation_of_146_men_with_incontinence_after_radical_prostatectomy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-4295(05)00336-5 DB - PRIME DP - Unbound Medicine ER -