Changes of urinary continence after TURP: A questionnaire based analysis

Introduction: The transurethral resection of the prostate (TURP) is the sta ndard operation of patients with benign prostatic hyperplasia (BPH). Urinar y incontinence after TURP is reported with a mean incidence of 2.1%. Detrus or instabilities appear in approximately 60% of the patients before and in 26% after TURP. It may be presumed that elimination of detrusor instabiliti es might improve continence. The aim of the study was to determine the alte ration of continence after TURP. Patients and methods: After a mean follow-up of 43 months (11.1 - 91.2) 99 patients (mean age 68 years) answered a questionnaire in which they recorde d the continence status pre- and postoperatively as well as the subjective changes of urinary continence using a Global Subjective Assessment Instrume nt with linear analogue scale (reaching from -100% to + 100%). The data of the questionnaire, age, follow-up time and the parameters of the preoperati ve urodynamic assessment were evaluated statistically. Results: Before TURP, 22.2% of the patients and after TURP, 12.1% of the pa tients were incontinent. Only 2% of the patients reported urinary incontine nce after TURP for the first time, while 12.1% became continent. 75.8% rema ined continent and 10.1% remained incontinent. Using the linear analogue sc ale, 56% of all patients indicated improved continence, 25% felt no change, and 19% reported about a deterioration of continence (mean change of subje ctive outcome + 21%). Only the status of renewed and sustained continence w as associated with subjective improvement of continence (p < 0.01, mean cha nge of subjective continence + 75% and + 17%, respectively). The subjective change of continence showed no correlation with the age of the patients (p = 0.54), duration of the follow-up period (p = 0.36) or subvesical obstruc tion (p = 0.378). Conclusions: The majority of patients report subjectively improved urinary continence after TURP. Urinary incontinence appears in 2% after TURP, but i ncontinence ceased in 12.1%.