Incontinence after retropubic radical prostatectomy: correlation between ultrasonographic morphological data and urodynamic parameters
Nacci, G.G.; Masiello, G.; Lorusso, A.; Maselli, F.P.; D'Achille, G.; Pagliarulo, A.
Archivio Italiano di Urologia Andrologia Organo Ufficiale di Societa Italiana di Ecografia Urologica e Nefrologica 74(4): 263-266
2002
ISSN/ISBN: 1124-3562 PMID: 12508745 Document Number: 542178
The aim of this study is to evaluate the relationships existing between transrectal ultrasound and urodynamics in patients undergone radical retropubic prostatectomy and affected by stress incontinence. 78 patients were suitabe for the study. They have been divided in three groups: group A, 18 incontinent patients (at least 1 pad a day); group B, 30 patients with occasional dribbling (no incontinence device needed); group C, 30 continent patients. All the patients have undergone urethral pressure profile (UPP), abdominal leak point pressure (ALPP) and transrectal ultrasound (TRUS). ultrasound has been performed injecting saline solution in the spongious and bulbar urethra to dilate it and better visualize a collapsed tract corresponding to the distal sphincter, that was measured. Different doctors performed TRUS and urodynamics, and each ignored the results of the other tests. The mean value of TRUS length of the collapsed urethral segment was 5.47 mm (range 4.9-6.0) for group A, 11.5 mm (9.5-12.9) for group B, 13.8 mm (10.4-14.7) for group C. the mean value of rest FUL was 36.6 (range 23-52) for group A, 31.7 (range 21-37) for group B, 13.8 (range 10.4-14.7) for group C. The mean value of stress FUL was 20.3 (range 5-29) for group A, 20.7 (range 18-27) for group B, 25.0 (range 20-35) for group C. The mean value of VLPP was 61.9 cm H2O for group A, 83.6 cm H2O for group B, > 90 cm H2O for group C. The ranges of values of VLPP were narrower and showed less overlap among the groups than UPP. TRUS length showed a good correlation with VLPP and permitted to differentiate incontinent patients from continent patients and patients with occasional dribbling. These data correlate well with the possible role of the length of the urethral stump and of damage to genitourinary diaphragm in post-prostatectomy incontinence.