Urinary Continence Evatuation In Patients Submitted To Radical Prostatectomy

Main Category: Urology / Nephrology
Article Date: 24 Sep 2007 - 0:00 PDT

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UroToday.com - Presented Wednesday, 05 September 2007 at the 29th Congress of the Societe International d'Urologie - SIU 2007 - Optimizing Clinical Outcomes in Prostate and Renal Cell Carcinomas - The Second Annual Symposium on Advanced GU Malignancy - Palais des Congres de Paris, France

Introduction & Objective: One of the best patients and surgeon preoccupations are the urinary dysfunction after retropubic radical prostatectomy (RRP). In yours different levels, urinary incontinence represent lost of life quality and in some cases, really social incapacity. The objective this study was evaluates urinary continence in patients submitted to RRP.

Methods: We evaluated 436 patients with localized prostate cancer submitted to RRP from 1990 February to 2005 April. Median age was 62.4 years (41-79). The patients were classified after RRP how urinary continence were: total continence (without any stress urinary incontinence), with stress incontinence (urinary loss during cough or levanter peso), urinary loss after some stress (diurnal urinary loss when walking, or lifting one chair) and severe urinary incontinence (night urinary loss, change of many pads during the day and indication to artificial sphincter implantation).

Results: Mean postoperative follow-up was 39.8 months (0.4-176). Urinary continence of 436 patients were evaluated in postoperative day 30th: total continence in 54.1%, stress incontinence in 42%, urinary loss after some stress in 3.4% and severe incontinence in 0.4% of cases. In 5a e 8a decades of the life, the total continence has been obtained in 77.4% e 43.4%, respectively. Final urinary continence improved with surgeon's experience and in this year was total continence in 88.2% and loss after stress urinary in 11.8% of the cases (p=0.0006). Patients with better erectile function preservation had better final urinary continence (p<0.001).Mean of surgery time was 238.7 minutes (range 105 to 525) and time of surgery has decreased in last years (p<0.001). Patients with time of RRP less than 240 minutes had best urinary continence (p<0.001). The surgeries and medical procedures associated with vesicourethral anastomosis abnormalities: 15 patients (3%) submitted to AMS urethral sphincter implantation, 60 patients (11.8%) submitted to internal urethrotomy and 14 patients (8.9%) urethral dilatation.

Conclusion: The mean tax of complete urinary continence in different experts Urology Services is 92%. The urinary continence is recovery earlier in youngest patients. The best results are associated with surgeons experience and improvement of operative technique.

Authors: Fonseca FP, Carlos S, Zequi SC, Guimaraãs GC, Francisco J, Nishimoto IN, Lopes A

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