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June 14, 2000

Genitourinary Consequences of Radical Prostatectomy

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Contributing EditorIndividualAuthor

JAMA. 2000;283(22):2932. doi:10.1001/jama.283.22.2931

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.