POSTPROSTATECTOMY INCONTINENCE - URODYNAMIC FINDINGS AND TREATMENT OUTCOMES

Purpose: We examined urodynamic findings and treatment outcomes in a l arge population of men with post-prostatectomy incontinence. Materials and Methods: A total of 215 men was referred for evaluation and treat ment of significant post-prostatectomy incontinence. Urodynamic evalua tion consisted of provocative multichannel medium fill cystometry with vigorous attempts to demonstrate incontinence. Treatment was directed by the results of the urodynamic study, A pad scoring system was used to gauge the severity of incontinence before and after treatment. Res ults: Based on the results of urodynamic studies 40% of the men had ge nuine stress incontinence alone and approximately 60% had a major comp onent of bladder dysfunction contributing to incontinence. Treatment r esults of 135 men demonstrated a significant decrease in pad score (p < 0.001) for those treated with anticholinergics, those undergoing art ificial sphincter insertion and those treated pharmacologically before sphincter placement. Conclusions: In our large series most men with p ost-prostatectomy incontinence did not have genuine stress incontinenc e alone. Thus, urodynamic studies are critical, not only to define the cause of incontinence but to direct effective therapy.