PROSPECTIVE ASSESSMENT OF INCONTINENCE AFTER RADICAL RETROPUBIC PROSTATECTOMY - OBJECTIVE AND SUBJECTIVE ANALYSIS

Objectives. To assess prospectively-using pad test and questionnaire-t he rate and degree of incontinence after radical retropubic prostatect omy, to analyze factors that may predispose individuals to postoperati ve incontinence, and to assess the impact of incontinence on patient l ifestyle. Methods. Fifty-one consecutive patients were assessed at 3-m onth intervals for I year after radical retropubic prostatectomy. Pati ents were objectively assessed using a 1-hour pad test and subjectivel y assessed by questionnaire. Incontinence was graded objectively accor ding to the change in weight of the pad at 1 hour and subjectively by the number of pads used per day. Lifestyle modifications were assessed by questionnaire at 12 months. A number of variable factors were stud ied to assess risk factors for postoperative incontinence. Results. Co ntinence continued to improve up to 12 months. At 12 months, pad testi ng revealed 84% of patients were dry, 6% were mildly incontinent, 6% w ere moderately incontinent, and 4% were severely incontinent. Question naire assessment revealed 80% wore no pad, 14% had mild incontinence, 4% had moderate incontinence, and 2% had severe incontinence. Pad test ing was not as sensitive as the questionnaire for the detection of min imal incontinence but was more reliable for moderate and severe levels . Patients made lifestyle changes proportional to the level of inconti nence. No predisposing factor was identified for the development of in continence after radical retropubic prostatectomy. Conclusions, Signif icant incontinence after radical prostatectomy occurs in as many as 10 % of patients. Pad testing provides an inexpensive and simple form of objective assessment in patients with bothersome incontinence and allo ws documentation of improvement over time. Copyright 1997 by Elsevier Science Inc.