INFLUENCE OF DESCENDING RADICAL PROSTATEC TOMY ON BLADDER AND CLOSUREFUNCTION - A URODYNAMIC STUDY

In 66 patients with localized prostate cancer and a mean age of 68.4 y ears, urodynamic studies were performed before radical retropubic pros tatectomy. Complete urodynamic work up was possible in 44/66 patients 2.5 to 19 months (mean: 7.6 months) after surgery. Preoperatively 21/6 6 patients (31.8%) demonstrated detrusor instability. Postoperatively, in 3/44 patients (6.8%), detrusor instability occurred. Maximal detru sor pressure, maximal urethral length, maximal urethral closure pressu re and maximal urethral closure pressure during voluntary contraction of the pelvic floor were significantly decreased after surgery. Urinar y incontinence was not caused by detrusor instability. A preoperative estimation of the individual postoperative risk of urinary incontinenc e was not possible. Intensive training of the pelvic floor is very imp ortant for achieving continence after radical prostatectomy.