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Abstract
To analyze the correlation between the "International Consultation on Incontinence Questionnaire-Short Form" (ICIQ-UISF) survey and the urodynamic findings in men with urinary incontinence (UI) following radical prostatectomy (RP). 88 men who presented post-RP UI for a minimum of 1 year were enrolled prospectively. All answered the ICIQ-UISF survey and underwent urodynamic testing. Patients were divided in 3 Groups according to their urodynamic diagnosis: Group 1, patients with sphincteric incontinence (SI) alone; Group 2, patients with mixed UI (SI + Bladder Dysfunction (BD)); and Group 3, patients with BD alone. Data were analyzed using SPSS v16.0 software. There were 51 men in Group 1 (57.9%); 30 in Group 2 (34%); and 7 (7.9%) in Group 3. BD was found in 37/88 patients (42%), but it was the main cause of UI in only 14 patients (15.9%). There was no statistically significant difference among the mean ICIQ-UISFs values from groups 1, 2, or 3 (p>0.05). The symptoms of stress incontinence correlated with the urodynamic finding of SI (r = 0.59), and complaints of urinary urgency correlated with the presence of detrusor overactivity (DO) (r = 0.37), but these complaints did not predict the main cause of UI. The etiology of UI following RP cannot be predicted by the ICIQ-UISF survey. Symptoms of stress and urge incontinence predict the findings of SI and DO on urodynamic tests, but they cannot ascertain the main cause of UI. Urodynamic testing remains the gold standard to assess the etiology of post-RP UI.
Highlights
Prostate cancer is the most common non-skin tumor that affects men
Our results demonstrated that sphincteric incontinence (SI) alone or in combination with bladder dysfunction (BD) is present in 92% (81/88) of patients with Urinary incontinence (UI) after Radical prostatectomy (RP)
A study by Twiss et al analyzing men with UI after RP found a positive correlation between the complaints of stress incontinence and the detection of SI by the urodynamic test[20]. Our study confirmed this finding, and we found a positive predictive value of 97% in patients with complaints of stress UI and a urodynamic diagnosis of SI
Summary
Prostate cancer is the most common non-skin tumor that affects men. There are approximately 210,000 cases of prostate cancer annually in the United States, and the vast majorities (90%) are clinically localized or regional at diagnosis[1]. Radical prostatectomy (RP) is one of the most frequent treatments performed for localized prostate cancer, and approximately 65.000 men undergo RP in the United Sates annually. Urinary incontinence (UI) is a well-known complication of RP and occurs in 2-87% of men after surgery[2,3]. Developed questionnaires to study the impact of post-RP UI on quality of life for patients. They found that half of the patients analyzed had daily urinary leakage, and 32% were using pads, diapers or a penile clamp
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