Consecutive evaluation of vesico-urethral function in patients undergoing radical retropubic prostatectomy

Abstract

We evaluated vesico-urethral function after radical retropubic prostatectomy in 18 male patients by consecutive urodynamic studies. At the time of the operation average age was 68 years with a range between 56 to 78 years old. The follow-up period after the operation was over 12 months in all patients. Pathological stage was T1 in 2, T2 in 6, T3 in 8 and T4 in 2 patients. Urodynamic evaluation including uroflowmetry, cystometry, urethral pressure profilometry (UPP) and external anal or urethral sphincter electromyography was performed before and 1, 3, 6 and 12 months after the operation. The status of postoperative urinary incontinence was reported by the patients. Sixty-five per cent of the patients revealed the low compliance bladder less than 10 ml/cm water at one month after the operation, however, most patients had normal vesical compliance and normal cystometrogram at 12 months. Both functional profile length (FPL) and maximum urethral closure pressure (UCPmax) in UPP were markedly lowered immediately after the operation and both indexes were significantly lower even at one year after the operation than preoperative ones. Both the incidence and the degree of incontinence improved during postoperative 12 months; complete urinary control was achieved in 11 patients (61%), stress urinary incontinence was present in 6 patients (33%) and one patient (6%) was still totally incontinent. Shortening FPL was considered to be the risk factor on postoperative urinary incontinence. Resection of bilateral neurovascular bundles and lower UCPmax seemed to have the possibility of the influence on it. Low compliance bladder is also likely to be one of the factors to cause early postoperative incontinence.