Urodynamic evaluation of incontinence in patients undergoing modified Campbell radical retropubic prostatectomy: a prospective study

Abstract

A prospective urodynamic study was performed on 17 consecutive patients undergoing a modified Campbell radical retropubic prostatectomy for prostatic carcinoma. There was 1 postoperative death, leaving 16 evaluable patients. Patients were evaluated preoperatively and at 6 weeks, 3 months and 6 months postoperatively. The only urodynamic parameter 6 months postoperatively that differed significantly from the preoperative value was the functional urethral length, 1.6 and 4.3 cm., respectively. The incidence of clinical and/or urodynamic urinary incontinence preoperatively was 19 per cent and 6 months after the procedure it was 87 per cent. The incontinence rate did not correlate with the pathological stage or histological grade of the tumor. There was a strong trend toward improvement of continence with time but all patients who were incontinent 6 months postoperatively and followed for more than 1 year remained incontinent. While this incontinence rate is the highest reported, we believe that it reflects detailed patient interviews and objective fluoroscopic evidence of urethral urinary loss. These results and those of others suggest that modification of the technique of radical prostatectomy to produce a functional urethral length of at least 2.8 cm. may be desirable.