Urinary Incontinence after Transvesical Prostatectomy

Abstract
34 patients with urinary incontinence after transvesical prostatectomy were reviewed. Detrusor hyperreflexia and sphincter damage were the most frequently encountered lesions. No correlation was found between the weight of the removed prostatic tissue and the incidence of sphincter damage, but the incidence of other urological complications was larger in the group of patients with small prostates. This suggests that these patients had other primary disorders or should have been treated transurethrally. Postprostatectomy incontinence due to sphincter damage had a better prognosis when the patients were referred within 1 year after surgery. This was ascribed partially to the high incidence of spontaneous cure in this group of patients. In the patients with detrusor hyperreflexia the prognosis was independent of the time interval between operation and referral. At the present time none of the conventional therapeutic modalities seem ideal, especially not in patients with sphincter damage. Finally, the importance of informing the patients of palliative measures is stressed in the attempt to improve the social adjustment of the patients.