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Artículo Tomo 71, Número. 6, Jul/Ago 2018

Archivos Españoles de Urología

Correlation between symptoms and urodynamic results in patients with urinary incontinence after radical prostatectomy.

Authors: José Medina-Polo, Ana Arrébola-Pajares, Susana de la Rosa-Kehrmann, Javier Romero-Otero, Borja García-Gómez, Manuel Alonso-Isa, Alba Lara-Isla, José Manuel Duarte-Ojeda, Alfredo Rodríguez-Antolín y Juan Bautista Passas-Martínez.

Arch. Esp. Urol. 2018; 71 (6): 523-530

Vol. 71, Number. 6, Jul/Aug 2018

OBJECTIVES: Urinary incontinence (UI) is a significant complication after radical prostatectomy (RP). Although sphincter incompetence is considered the main cause; bladder dysfunction can contribute substantially. Our objective was to evaluate the results of the urodynamic study (UDS) in men with UI after radical prostatectomy and analyze the correlation between symptoms and urodynamic parameters.

METHODS: We carried out a retrospective study reviewing the symptoms and urodynamics in patients with urinary incontinence after RP. We describe the symptoms, urodynamic findings and we analyze the correlation between both.

RESULTS: Our study included 74 patients. The median number of pads used per day was 3. 61% reported urgency, 63% stress urinary incontinence, 11% urgency urinary incontinence and 26% mixed urinary incontinence. The UDS showed stress urinary incontinence in 53% of patients, detrusor overactivity in 53% and, reduced bladder compliance in 43%. Urgency urinary incontinence was reported in 56% of patients with reduced bladder compliance. Urodynamics showed no incontinence in 16% of patients, of whom 80% showed urgency urinary incontinence. Urodynamics data showing obstruction of the urinary tract was reported in 17% and detrusor hypo or acontractility in 36%. Among patients with obstruction, 46% showed incontinence due to detrusor overactivity. The correlation of symptoms and urodynamics showed that only 31% of patients with stress urinary incontinence had incontinence due to detrusor overactivity in urodynamics. Among those with mixed urinary incontinence, urodynamic stress urinary incontinence only was found in 42% and 33% incontinence due to detrusor overactivity only. Finally, among those with symptoms of urgency urinary incontinence, the urodynamics showed detrusor overactivity in 27%.

CONCLUSIONS: In patients with urinary incontinence after radical prostatectomy, there is a high percentage of patients with urinary tract obstruction, detrusor overactivity and decreased compliance. Moreover, the correlation between symptoms and urodynamics is low.

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