Urinary bladder hypertrophy and overactive bladder determine urinary continence after radical prostatectomy.

BACKGROUND

Several clinical and biological factors exacerbate urinary incontinence (UI) and reduce the patient's quality of life after radical prostatectomy (RP).

OBJECTIVES

The purpose of this study was to evaluate the effects of urinary bladder hypertrophy and overactive bladder (OAB) on UI in patients after RP.

MATERIAL AND METHODS

Seventy patients were enrolled in the study and were divided into 2 groups: patients with bladder outlet obstruction (BOO) but without OAB (group I; n = 20) and patients with BOO and OAB (group II; n = 50). Before the RP procedure, all patients were administered IPSS and OAB symptom questionnaires and ultrasonography and uroflowmetry were performed. The follow-up visits were scheduled for 1, 3, 6, 9, and 12 months after the operation to evaluate postoperative continence.

RESULTS

The results show that patients with BOO and concurrent OAB experienced urinary bladder hypertrophy. Patients with OAB presented a normal desire to void with less urinary bladder capacity. The coexistence of OAB before RP resulted in more extensive UI, as measured with the ICIQ-UI-SF scores and postoperative daily pad usage. A gradual improvement in urinary continence was observed. Urinary incontinence was significantly less severe in successive check-ups (3, 6, 9, and 12 months after RP). Urgency was responsible for 1-15% or 16-29% of episodes of urinary leakage in 20% and 16% of cases, respectively.

CONCLUSIONS

Patients with preoperative OAB are at a higher risk of developing more severe UI after RP, and the restoration of pre-surgery urinary continence is limited.