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Órgano Oficial de el Colegio Mexicano de Urología

2003, Number 1

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Bol Col Mex Urol 2003; 18 (1)

Urodynamic and radiologic evaluation in the prediction of risk from urinary incontinence in patients with clinically localized prostate cancer undergone to retropubic radical prostatectomy

Serrano BEA, Lorenzo MJL, Wingartz PHF, Moreno AJO, Fuentes GMA

Language: Spanish
References: 20
Page: 15-19
PDF size: 50.64 Kb.


ABSTRACT

Today radical retropubic prostatectomy (RRP) is the choice procedure and best alternative for localized prostate cancer treatment in selected patients. A potential complication of this procedure is severe urinary incontinence, that can be related to sphincteric damage and less frequent with bladder injury. Sphincteric incompentence has been attributed to ischemia, scars, atrophy and structural sphincteric injury or damage to pudendal nerve which produces membranous urethral alteration under its length an critical pressure to maintain urinary continence. The objective of this study was to evaluate sphincteric urethra before and after RRP to detect anatomic and functional variations that can lead development of urinary incontinence after RPP. We perform urodynamic and radiologic evaluation to 38 patients with median age of 62.8 years, with clinically localized prostate cancer, undergone to RPP. Twenty eight had total urinary continence, 7 with mild incontinence (group I) and 3 with severe incontinence (group II). Before RPP functional urethral length (FUL) and maximum urethral closure pressure (MUCP) were higher for group II (P = 0.015 and 0.02 respectively); membranous urethral radiological length (MURL) and urethral closure total area (UCTA) showed no difference between both groups. After RPP were statistically significant difference between all parameters (MURL, FUL, MUCP and UCTA) in group II patients compared with group I patients. Conclusion: Anatomic and functional variations of sphincteric urethra before to RRP, do not determine development of postoperative urinary incontinence, therefore RPP itself is the responsible of sphincteric damage.


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