Preoperative and operative factors to predict incontinence, impotence and stricture after radical prostatectomy

J. W. Moul*, R. M. Mooneyhan, T. C. Kao, D. G. McLeod, D. F. Cruess

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

44 Scopus citations


The purpose of this study was to determine the incidence of patient-self reported post prostatectomy incontinence, impotence, bladder neck contracture or stricture, better, same or worse quality of life and willingness for same treatment again in a large group of radical prostatectomy (RP) patients and to determine if these morbidities are predictable with demographic, surgical or prostate cancer (PC) factors. Methods: A patient self-reporting questionnaire was completed and returned by 374 out of 458 eligible (81.7%) RP patients from one center, 267 (72.2%) have been operated since 1990 and all of whom were a minimum six month postoperative (75%>1y). Questionnaire results were independently analyzed by a third party and correlated to demographic, operative, and tumor factors in an ongoing comprehensive PC database. Results: The patient self-reported incidence of post prostatectomy incontinence (any degree), impotence, and bladder neck contracture or stricture was 72.2, 87.4, and 25.9%, respectively. The reported rate of incontinence requiring protection was 39.0% and only 2.4% had persistent bladder neck contracture/stricture. Pathologic stage (continuous variable) was the only factor to significantly predict incontinence and no factor could predict impotence or bladder neck contracture/ stricture in univariate analysis. No factor was predictive of morbidity by multivariate analysis. Despite incontinence and impotence significantly affecting QOL self-reporting (P = 0.001, 0.001, respectively) and willingness to undergo RP again (P= 0.001, 0.067, respectively), the majority of patients would choose surgery again. Conclusions: Although radical prostatectomy morbidity is common and affects patient-reported overall QOL, most patients would choose the same treatment again. Demographic, preoperative, operative, and tumor factors did not reliably predict patient-reported morbidity in this series.

Original languageEnglish
Pages (from-to)242-249
Number of pages8
JournalProstate Cancer and Prostatic Diseases
Issue number5
StatePublished - 1998


  • Cancer
  • Impotence
  • Incontinence
  • Prostate
  • Radical prostatectomy
  • Stricture


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