Urinary Incontinence after Radical Prostatectomy. Neurophysiological and Urodynamic Diagnosis

Abstract

Objectives.

Urinary incontinence after radical prostatectomy presents different clinical features. We propose to clarify the etiology and the therapeutic approaches.

Methods.

51 patients with urinary incontinence after radical prostatectomy underwent urodynamics, perineal EMG, perineal EMG frequency analysis and study of computerized sensory pudendal somatosensory evoked potentials.

Results.

18 patients (35%) were suffering from urinary incontinence secondary to overactive bladder, 14 patients (28%) had both an overactive bladder and a sphincter failure associated with Wallerian degenerative axonal neuropathy or segmental demyelination, 3 patients (6%) showed no significant urodynamics alterations but had signs of an incompetent sphincter neurapraxia, while 16 patients (31%) had urinary incontinence secondary to a degenerative neuropathy.

Conclusions.

Urinary incontinence after radical prostatectomy shows an etiologic diversification and therefore requires different therapeutic approaches.