URINARY CONTINENCE AFTER RADICAL PROSTATECTOMY - THE COLUMBIA EXPERIENCE

Purpose: We determine the incidence of urinary incontinence after radi cal prostatectomy and the factors that may influence this incidence. M aterials and Methods: A total of 615 men who underwent radical retropu bic prostatectomy performed by 1 of us (C. A. O. or M. C. B.) at our c enter between 1988 and 1996 were mailed a questionnaire regarding preo perative and postoperative voiding habits. Data collected included pre operative and postoperative continence status, interval to postoperati ve continence status, associated urinary symptoms, willingness to unde rgo radical prostatectomy again if given the chance and additional pos toperative procedures. Patient age, date of surgery and duration of fo llowup were also noted. Results: Of the 615 patients 480 (78.2%), a me an of 62.6 years old, responded to the questionnaire. Mean followup wa s 3.3 years (range 1 to 8.8). Continence was defined as no regular use of pads. Of the respondents 91.8% were considered continent, 92% had achieved final continence status by 6 months postoperatively, 10.6% re quired 1 or more additional procedures related to urinary control and 90% would undergo surgery again if given the chance. Of the patients c onsidered incontinent postoperatively 44% had associated urgency. Age, year of surgery and preoperative urinary leakage or post-void dribbli ng had no significant impact on postoperative continence status. Concl usions: Using an anonymous self-administered questionnaire we found an 8.2% incontinence rate after radical prostatectomy. This rate was sim ilar to that in large, single institutional studies in which physician interview was used to elicit responses but significantly less than th at in a national sample of Medicare patients also given a self-adminis tered questionnaire. With minimal potential for adverse consequences i n the hands of experienced surgeons, radical prostatectomy remains wel l tolerated with excellent patient satisfaction.