Risk Factors for Urinary Incontinence after Radical Prostatectomy

No AccessJournal of UrologyClinical Urology: Original Article1 Nov 1996Risk Factors for Urinary Incontinence after Radical Prostatectomy James A. Eastham, Michael W. Kattan, Eamonn Rogers, Jeremy R. Goad, Makoto Ohori, Timothy B. Boone, and Peter T. Scardino James A. EasthamJames A. Eastham , Michael W. KattanMichael W. Kattan , Eamonn RogersEamonn Rogers , Jeremy R. GoadJeremy R. Goad , Makoto OhoriMakoto Ohori , Timothy B. BooneTimothy B. Boone , and Peter T. ScardinoPeter T. Scardino View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)65488-0AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We identified risk factors associated with urinary incontinence after radical retropubic prostatectomy. Materials and Methods: The time from operation until urinary continence was achieved was determined by chart review and questionnaire in 581 patients who were continent before undergoing radical retropubic prostatectomy between 1983 and 1994. Using univariate and multivariate analyses of data gathered prospectively, we examined risk factors associated with incontinence in these patients. Results: The actuarial rate of urinary continence at 24 months was 91 percent for the entire patient populations and 95 percent for those treated after 1990. Many factors were associated with the risk of incontinence in univariate Cox proportional hazards regression analysis (patient age and weight, degree of obstructive voiding symptoms, prior transurethral resection of the prostate, clinical stage, intraoperative blood loss, resection of neurovascular bundles, postoperative anastomotic stricture and technique of vesicourethral anastomosis). However, in a multivariate analysis the factors that were independently associated with increased chance of regaining continence were decreasing age, a modification in the technique of anastomosis (introduced in 1990), preservation of both neurovascular bundles and absence of an anastomotic stricture. With introduction of the new surgical technique in 1990 the median time to continence decreased from 5.6 to 1.5 months and the rate of continence at 24 months increased from 82 to 95 percent. Conclusions: While the risk of urinary incontinence after radical prostatectomy is related to the uncontrollable factor of patient age, it is also sensitive to the surgical technique used. References 1 : Impact of anatomical radical prostatectomy on urinary continence. J. Urol.1991; 145: 512. Link, Google Scholar 2 : Return of erections and urinary continence following nerve sparing radical retropubic prostatectomy. J. Urol.1993; 150: 905. Link, Google Scholar 3 Stapleton, A. M. F. and Scardino, P. 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Google Scholar Matsunaga-Conte Prostate Cancer Research Center and the Scott Department of Urology, Information Technology Program, Baylor College of Medicine, and The Methodist Hospital, Houston, Texas.© 1996 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited ByNelson M, Dornbier R, Kirshenbaum E, Eguia E, Sweigert P, Baker M, Farooq A, McVary K, Gonzalez C, Gupta G and Bresler L (2019) Use of Surgery for Post-Prostatectomy IncontinenceJournal of Urology, VOL. 203, NO. 4, (786-791), Online publication date: 1-Apr-2020.Sandhu J, Breyer B, Comiter C, Eastham J, Gomez C, Kirages D, Kittle C, Lucioni A, Nitti V, Stoffel J, Westney O, Murad M and McCammon K (2019) Incontinence after Prostate Treatment: AUA/SUFU GuidelineJournal of Urology, VOL. 202, NO. 2, (369-378), Online publication date: 1-Aug-2019.Avulova S, Zhao Z, Lee D, Huang L, Koyama T, Hoffman K, Conwill R, Wu X, Chen V, Cooperberg M, Goodman M, Greenfield S, Hamilton A, Hashibe M, Paddock L, Stroup A, 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Volume 156Issue 5November 1996Page: 1707-1713 Advertisement Copyright & Permissions© 1996 by American Urological Association, Inc.MetricsAuthor Information James A. Eastham More articles by this author Michael W. Kattan More articles by this author Eamonn Rogers More articles by this author Jeremy R. Goad More articles by this author Makoto Ohori More articles by this author Timothy B. Boone More articles by this author Peter T. Scardino More articles by this author Expand All Advertisement PDF DownloadLoading ...