Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Contributing EditorIndividualAuthor
To the Editor: In their study on urinary and
sexual function after radical prostatectomy, Dr Stanford and colleagues1 did not differentiate stress incontinence from
detrusor instability or hyperreflexia from other neurologic causes of incontinence.
Many older men have some form of detrusor instability from simple enlargement
of the prostate. Another group of men experience symptoms of detrusor hyperreflexia
either from central nervous system disorders, spinal cord lesions, or other
systemic illnesses. Preexisting urgency incontinence needs to be differentiated
from stress incontinence due to prostatectomy. Detrusor instability and hyperreflexia
can be treated adequately with anticholinergic drugs and a large percentage
of men with these conditions can be markedly relieved of their incontinence
symptoms if the appropriate diagnosis is made.
Rockoff SD. Genitourinary Consequences of Radical Prostatectomy. JAMA. 2000;283(22):2932. doi:10.1001/jama.283.22.2931