Do low urinary tract symptoms influence postprostatectomy urinary incontinence?

AIM - To analyse what urinary symptoms have patients before receive treatment by radical prostatectomy(RP) and to evaluate their influence over 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 - 661 patients were included on analysis. 136 (20.6%) patients referred any LUTS. 162 (24.5%) were considered incontinent after RP, 45 (33.1%) of those reported LUTS before surgery. PPUI is significantly different between 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 (CI 95%:1.14-2.6),p=0.01]. TURP is independently influential in PPUI [OR:6.13 (CI 95%: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 pre-operative consultation is important to assess continence status and to create realistic expectations to patients before RP.

Minerva Urol Nefrol. 2015 Jul 29. [Epub ahead of print]

Tienza A1, Hevia M, Merino I, Diez-Caballero F, Rosell D, Pascual JI, Zudaire JJ, Robles JE.

Department of Urology, Clinica Universidad de Navarra, Pamplona, Spain 

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