A clinical evaluation on postprostatectomy incontinence

: Postprostatectomy incontinence was evaluated in 193 patients, who underwent retropubic prostatectomy (RPP) or transurethral resection of the prostate (TURP) during the past 5 years from 1985 to 1989 at the Kyoto Prefectural University of Medicine. The occurrence rate of postprostatectomy incontinence was 17.2% in the patients who had undergone RPP and 33.3% of those who had undergone TURP. Although postprostatectomy incontinence disappeared within one week in half of the patients, postprostatectomy incontinence remained for more than one month in 4.9% of the patients who had undergone RPP and 3.3% of those who had undergone TURP. The incidence of postprostatectomy incontinence tended to be high in the patients of advanced ages. Postprostatectomy incontinence recognized in this series was classified into stress incontinence and urgency incontinence groups. An analysis of the results of cystometry performed before the operation showed that the volume of maximum desire of voiding in the urgency incontinence group was smaller than that in the group without postprostatectomy incontinence. Furthermore, supposing the urgency degree as a new parameter, which is defined as a ratio of first desire of voiding to maximum desire of voiding, the urgency degree of the urgency incontinence group was higher than that of the group without postprostatectomy incontinence. Patients with an urgency degree higher than 70% were found to have a high probability of urgency incontinence. These findings suggested that advanced age was the risk factor of postprostatectomy incontinence and that a small bladder capacity and high urgency degree were the high risk factors of postprostatectomy urgency incontinence.