What makes men leak? An investigation of objective and self-report measures of urinary incontinence early after radical prostatectomy

AimsPelvic floor muscle training for patients having radical prostatectomy promotes contraction of these muscles in anticipation of activities that may provoke urine leakage. The aims of this study were: to determine the contribution of the individual activities comprising a standardised 1-hour pad test (1HPT) to overall urine leakage early after radical prostatectomy; and to investigate relationships between the 1HPT, 24-hour pad test (24HPT) and the International Consultation on Incontinence QuestionnaireShort Form (ICIQ-SF) early after radical prostatectomy.

MethodsA prospective analysis of patients having radical prostatectomy and receiving pelvic floor muscle training (n=33). Participants completed the 1HPT, 24HPT and ICIQ-SF at 3 and 6 weeks postoperatively. Participants wore a separate, pre-weighed continence pad for each of the seven activities comprising the 1HPT; pads were weighed separately and together to calculate activity-related and overall urine leakage.

ResultsWalking at a comfortable speed and drinking while sitting were the two activities contributing most to overall urine leakage, albeit these activities also comprised 75% of 1HPT time. All component activities contributed a minimum 75% of overall urine leakage. There were significant and strong to very strong correlations between all of the 1HPT, 24HPT, and ICIQ-SF at 3 weeks postoperatively. There were significant decreases in 24HPT (P=0.032) and ICIQ-SF (P=0.001) but no significant change in 1HPT from 3 to 6 weeks postoperatively.

ConclusionsPelvic floor muscle training should include contraction of these muscles in sedentary and walking postures. The 1HPT correlates well with the 24HPT, but may not be sensitive to early postoperative improvements in urinary leakage. Neurourol. Urodynam. 35:225-229, 2016. (c) 2014 Wiley Periodicals, Inc.