POST-PROSTATEKTOMİ İNKONTİNANSTA İNTRİNSİK SFİNKTER DİSFONKSİYONU DIŞINDAKİ NEDENLER DE AKILDA BULUNDURULMALIDIR

Abstract

Objective: This study aims to determine the causes of urinary incontinence and accompanying bladder pathologies in patients with persistent incontinence 12 months after radical prostatectomy. Methods: Thirty-four patients who underwent open radical retropubic prostatectomy (RRP) due to localized prostate cancer and incontinent after surgery between January 2015 and December 2020 and underwent urodynamic study (UDS) were retrospectively reviewed. All UDSs were performed according to the ICS protocol of good urodynamic practice and assessed by the same doctor. Patients were assessed by demographic and clinical parameters including age, body mass index (BMI), comorbidity, preoperative PSA level, prostate volume (PV), transrectal prostate biopsy Gleason score, clinical stage, pathological ISUP grade, pathological stage, lymph node positivity, international consultation on incontinence questionnaire-short form and subjective questionnaire for daily pad use. Results: Urodynamic studies showed that 29 patients (85.2%) had intrinsic sphincter deficiency (ISD). Nine (26.4%) of 29 patients with ISD had a secondary diagnosis of overactive bladder (OAB), impaired detrusor contractility (IDC) and OAB+IDC 9 (11.6%), 4 (11.6%), 1 (2.9%), respectively. Nineteen patients (55.8%) had a sole diagnosis of ISD, whereas 15 patients (44.1%) had another primary diagnosis or a secondary diagnosis other than ISD. Conclusion: Although ISD is the most common cause of persistent urinary incontinence in patients after radical prostatectomy, it should be taken into account that overactive bladder and impaired detrusor contractility are also accompanied by a significant proportion of patients.