The pathophysiology of post-radical prostatectomy incontinence: A clinical and video urodynamic study

Asnat Groutz, Jerry G. Blaivas, David Chaikin, Jeffrey P. Weiss, Michael Verhaaren

Research output: Contribution to journalArticle

161 Citations (Scopus)

Abstract

Purpose: We examine various mechanisms of post-radical prostatectomy incontinence. Materials and Methods: A total of 83 consecutive men (mean age 68 ± 6.6 years) referred for evaluation of persistent post-radical prostatectomy incontinence were enrolled in the study. All patients underwent clinical and urodynamic evaluation. Final diagnosis was based on clinical judgment considering patient history, pad test, voiding diary, free (unintubated) uroflow measurements, video urodynamics and linear passive urethral resistance relation curves. We compared free uroflow and pressure flow obtained with a 7Fr urethral catheter in place, and empirically defined low urethral compliance as at least 10 ml. per second difference between these measurements. Results: Sphincteric incontinence was the most common urodynamic finding, occurring in 73 patients (88%). Detrusor instability was identified in 28 patients (33.7%) and in 6 (7.2%) was the main cause of incontinence. In 2 other patients bladder outlet obstruction (1.2%) or impaired detrusor contractility (1.2%) was the only urodynamic finding. Impaired detrusor contractility was diagnosed by linear passive urethral resistance relation in 82% of cases but considered to be clinically relevant in only a third. In 25 cases (30.1%) low urethral compliance was noted, which we consider nearly synonymous with urethral scarring. Conclusions: Sphincteric incontinence is the most common urodynamic finding in patients with post-radical prostatectomy incontinence, although other findings may coexist. The most accurate diagnosis is attained when all objective measures are put in perspective with the clinical setting.

Original languageEnglish (US)
Pages (from-to)1767-1770
Number of pages4
JournalJournal of Urology
Volume163
Issue number6
DOIs
StatePublished - Jan 1 2000
Externally publishedYes

Fingerprint

Urodynamics
Prostatectomy
Compliance
Urinary Bladder Neck Obstruction
Urinary Catheters
Cicatrix
Pressure

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Groutz, Asnat ; Blaivas, Jerry G. ; Chaikin, David ; Weiss, Jeffrey P. ; Verhaaren, Michael. / The pathophysiology of post-radical prostatectomy incontinence : A clinical and video urodynamic study. In: Journal of Urology. 2000 ; Vol. 163, No. 6. pp. 1767-1770.
@article{7575a736fd1c442480dc3244ffc0bf08,
title = "The pathophysiology of post-radical prostatectomy incontinence: A clinical and video urodynamic study",
abstract = "Purpose: We examine various mechanisms of post-radical prostatectomy incontinence. Materials and Methods: A total of 83 consecutive men (mean age 68 ± 6.6 years) referred for evaluation of persistent post-radical prostatectomy incontinence were enrolled in the study. All patients underwent clinical and urodynamic evaluation. Final diagnosis was based on clinical judgment considering patient history, pad test, voiding diary, free (unintubated) uroflow measurements, video urodynamics and linear passive urethral resistance relation curves. We compared free uroflow and pressure flow obtained with a 7Fr urethral catheter in place, and empirically defined low urethral compliance as at least 10 ml. per second difference between these measurements. Results: Sphincteric incontinence was the most common urodynamic finding, occurring in 73 patients (88{\%}). Detrusor instability was identified in 28 patients (33.7{\%}) and in 6 (7.2{\%}) was the main cause of incontinence. In 2 other patients bladder outlet obstruction (1.2{\%}) or impaired detrusor contractility (1.2{\%}) was the only urodynamic finding. Impaired detrusor contractility was diagnosed by linear passive urethral resistance relation in 82{\%} of cases but considered to be clinically relevant in only a third. In 25 cases (30.1{\%}) low urethral compliance was noted, which we consider nearly synonymous with urethral scarring. Conclusions: Sphincteric incontinence is the most common urodynamic finding in patients with post-radical prostatectomy incontinence, although other findings may coexist. The most accurate diagnosis is attained when all objective measures are put in perspective with the clinical setting.",
author = "Asnat Groutz and Blaivas, {Jerry G.} and David Chaikin and Weiss, {Jeffrey P.} and Michael Verhaaren",
year = "2000",
month = "1",
day = "1",
doi = "10.1016/S0022-5347(05)67538-6",
language = "English (US)",
volume = "163",
pages = "1767--1770",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "6",

}

The pathophysiology of post-radical prostatectomy incontinence : A clinical and video urodynamic study. / Groutz, Asnat; Blaivas, Jerry G.; Chaikin, David; Weiss, Jeffrey P.; Verhaaren, Michael.

In: Journal of Urology, Vol. 163, No. 6, 01.01.2000, p. 1767-1770.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The pathophysiology of post-radical prostatectomy incontinence

T2 - A clinical and video urodynamic study

AU - Groutz, Asnat

AU - Blaivas, Jerry G.

AU - Chaikin, David

AU - Weiss, Jeffrey P.

AU - Verhaaren, Michael

PY - 2000/1/1

Y1 - 2000/1/1

N2 - Purpose: We examine various mechanisms of post-radical prostatectomy incontinence. Materials and Methods: A total of 83 consecutive men (mean age 68 ± 6.6 years) referred for evaluation of persistent post-radical prostatectomy incontinence were enrolled in the study. All patients underwent clinical and urodynamic evaluation. Final diagnosis was based on clinical judgment considering patient history, pad test, voiding diary, free (unintubated) uroflow measurements, video urodynamics and linear passive urethral resistance relation curves. We compared free uroflow and pressure flow obtained with a 7Fr urethral catheter in place, and empirically defined low urethral compliance as at least 10 ml. per second difference between these measurements. Results: Sphincteric incontinence was the most common urodynamic finding, occurring in 73 patients (88%). Detrusor instability was identified in 28 patients (33.7%) and in 6 (7.2%) was the main cause of incontinence. In 2 other patients bladder outlet obstruction (1.2%) or impaired detrusor contractility (1.2%) was the only urodynamic finding. Impaired detrusor contractility was diagnosed by linear passive urethral resistance relation in 82% of cases but considered to be clinically relevant in only a third. In 25 cases (30.1%) low urethral compliance was noted, which we consider nearly synonymous with urethral scarring. Conclusions: Sphincteric incontinence is the most common urodynamic finding in patients with post-radical prostatectomy incontinence, although other findings may coexist. The most accurate diagnosis is attained when all objective measures are put in perspective with the clinical setting.

AB - Purpose: We examine various mechanisms of post-radical prostatectomy incontinence. Materials and Methods: A total of 83 consecutive men (mean age 68 ± 6.6 years) referred for evaluation of persistent post-radical prostatectomy incontinence were enrolled in the study. All patients underwent clinical and urodynamic evaluation. Final diagnosis was based on clinical judgment considering patient history, pad test, voiding diary, free (unintubated) uroflow measurements, video urodynamics and linear passive urethral resistance relation curves. We compared free uroflow and pressure flow obtained with a 7Fr urethral catheter in place, and empirically defined low urethral compliance as at least 10 ml. per second difference between these measurements. Results: Sphincteric incontinence was the most common urodynamic finding, occurring in 73 patients (88%). Detrusor instability was identified in 28 patients (33.7%) and in 6 (7.2%) was the main cause of incontinence. In 2 other patients bladder outlet obstruction (1.2%) or impaired detrusor contractility (1.2%) was the only urodynamic finding. Impaired detrusor contractility was diagnosed by linear passive urethral resistance relation in 82% of cases but considered to be clinically relevant in only a third. In 25 cases (30.1%) low urethral compliance was noted, which we consider nearly synonymous with urethral scarring. Conclusions: Sphincteric incontinence is the most common urodynamic finding in patients with post-radical prostatectomy incontinence, although other findings may coexist. The most accurate diagnosis is attained when all objective measures are put in perspective with the clinical setting.

UR - http://www.scopus.com/inward/record.url?scp=0034119872&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034119872&partnerID=8YFLogxK

U2 - 10.1016/S0022-5347(05)67538-6

DO - 10.1016/S0022-5347(05)67538-6

M3 - Article

C2 - 10799178

AN - SCOPUS:0034119872

VL - 163

SP - 1767

EP - 1770

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 6

ER -