Fecal incontinence after radical perineal prostatectomy: A prospective study (original) (raw)
Related papers
Post-Prostatectomy Urinary Incontinence: A Confluence of 3 Factors
Journal of Urology, 2010
Purpose: Urinary incontinence has a significant impact on the quality of life of patients who undergo radical prostatectomy for prostate cancer. We reviewed available published data to analyze the etiology and prevention of this surgical complication. Materials and Methods: A MEDLINE® search of the literature on this topic was performed. Results: There was a wide disparity in the reported rates of urinary incontinence after radical prostatectomy due to various reasons including definitions, patient selection and intraoperative technical factors. Conclusions: Postoperative urinary incontinence has a major impact on patient satisfaction after radical prostatectomy. Attention to factors including patient selection, nuances of the surgical technique, and a more uniform, widespread agreement on the definition and instruments to measure postoperative incontinence is needed to enhance surgical outcomes. In addition, further research is needed to improve the diagnosis and treatment of urinary incontinence after prostate cancer surgery.
Late-onset incontinence in a cohort of radical prostatectomy patients
International Journal of Urology, 2011
A cohort of 235 subjects, who underwent radical prostatectomy from 1994 to 2002, completely continent at the 2-year follow up and with the last follow-up visit in 2009, was examined to assess incidence and risk factors of late-onset incontinence. Median follow up was 100 months, range 84-176. At the last follow-up visit, 209 (89%) maintained continence, and 26 (11%) became incontinent. Specifically 14 out of 26 (6%) used one pad and 12 (5%) used two or more pads daily. Incidence of age Ն65 years at radical prostatectomy was greater in the subgroup who developed late incontinence, 109/209 (52%) vs 19/26 (73%). Incidence of adjuvant or salvage radiotherapy, of hormonal manipulation and of extraprostatic disease was similar in the two subgroups. Univariate and multivariate analysis did not disclose any difference. Late-onset incontinence is to be expected in about 10% of subjects who became completely continent after radical prostatectomy. The cause is likely to be related to ageing. Patients should be informed about the long-term risk of becoming incontinent.
Prostate Cancer and Prostatic Diseases, 2004
Purpose: To assess fecal incontinence rates and bowel function for radical perineal (RPP) or radical retropubic (RRP) prostatectomy patients and to compare them with a matched control group. Methods: The bowel function domain of the Expanded Prostate Cancer Index Composite (EPIC) was mailed to 150 consecutive patients who had undergone RPP (79) or RRP (71) by the same surgeon (HJK) and an age-matched control group (75). Results: Fecal incontinence and bowel dysfunction were statistically equivalent for the study groups. Conclusions: There is no difference in fecal incontinence rates or bowel function when comparing RPP patients to RRP or control patients.
Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica, 2017
To study whether there are factors related to secondary diagnoses (SDg) present in patients with prostate cancer that influence the development of urinary incontinence after radical prostatectomy (RP). A retrospective multicenter observational study was performed reviewing the medical records of 430 men who underwent RP due to organ-confined prostate cancer in 9 different hospitals. Two study groups were distinguished: Group A (GA): Patients without urinary incontinence after RP; Group B (GB): patients with any degree of post-surgical urinary incontinence. Average age at surgery was 63.42 years (range 45-73). 258 patients were continent after surgery and 172 patients complaint of any degree of incontinence after RP. A higher percentage of healthy patients was found in group A (continent after surgery) than in group B (p = 0.001). The most common SDg prior to surgery were hypertension, lower urinary tract symptoms, dyslipidemia, diabetes mellitus and erectile dysfunction, but none di...
Post-prostatectomy incontinence: Etiology, evaluation, and management
Türk Üroloji Dergisi/Turkish Journal of Urology, 2014
Urinary incontinence after prostatectomy or radiation is a devastating problem in men and remains the most feared complication following the treatment of localized prostate cancer. With an increasing number of radical prostatectomies performed globally for prostate cancer, the impact of urinary incontinence on quality of life assumes an even greater importance. With the advent of male sling procedures, more men are now seeking treatment for incontinence. Since the introduction of the artificial urinary sphincter almost four decades ago, several surgical procedures have emerged to manage post-prostatectomy incontinence, including the male sling for milder forms of incontinence. Several of the newer procedures have shown promise in the United States; many others have been developed and utilized in other parts of the world, though they have not yet gained FDA approval in the United States. The present review seeks to illuminate the etiology, evaluation, and management of post-prostatectomy incontinence. An effort has been made to provide an algorithm to clinicians for appropriate surgical management. The surgical techniques of commonly performed procedures and their outcomes are described.
Urology, 1997
Objectives. To assess prospectively-using pad test and questionnaire-the rate and degree of incontinence after radical retropubic prostatectomy, to analyze factors that may predispose individuals to postoperative incontinence, and to assess the impact of incontinence on patient lifestyle. Methods. Fifty-one consecutive patients were assessed at 3-month intervals for 1 year after radical retropubic prostatectomy. Patients were objectively assessed using a 1 -hour pad test and subjectively assessed by questionnaire. Incontinence was graded objectively according to the change in weight of the pad at 1 hour and subjectively by the number of pads used per day. Lifestyle modifications were assessed by questionnaire at 12 months. A number of variable factors were studied to assess risk factors for postoperative incontinence. Results. Continence continued to improve up to 12 months. At 12 months, pad testing revealed 84% of patients were dry, 6% were mildly incontinent, 6% were moderately incontinent, and 4% were severely incontinent. Questionnaire assessment revealed 80% wore no pad, 14% had mild incontinence, 4% had moderate incontinence, and 2% had severe incontinence. Pad testing was not as sensitive as the questionnaire for the detection of minimal incontinence but was more reliable for moderate and severe levels. Patients made lifestyle changes proportional to the level of incontinence. No predisposing factor was identified for the development of incontinence after radical retropubic prostatectomy. Conclusions. Significant incontinence after radical prostatectomy occurs in as many as 10% of patients. Pad testing provides an inexpensive and simple form of objective assessment in patients with bothersome incontinence and allows documentation of improvement over time.
2004
Urinary incontinence after prostatectomy is a common problem. The literature on urinary incontinence following rrealment for localized prostate cancer is reviewed. Special focus is placed on the rate of urinary incontinence following different modes of therapy, the effect of post-treatment urinary inconrinence on parienrs' qualiry of life, and the success of different methods used to treat the inconci nence. Good patient communication can also help improve the qualiry of life in the early post-treatment period.