The phenomenon of incontinence after prostatectomy is still a subject of controversy. Many approaches to treatment exist, yet none is entirely satisfactory. The assumption that postprostatectomy incontinence is mainly due to injury to the external sphincter is not supported by experimental or clinical data. Actually, it is the loss of sphincteric closure pressure of the smooth component that is responsible for the incontinence, as urodynamic studies clearly show. To confront the problem rationally—even better, to prevent it—we must understand thoroughly the basic anatomy, physiology, and urodynamic characteristics of the lower urinary tract and the deviations from the normal that often occur after prostatectomy.
KeywordsBladder Neck Upright Position Pressure Profile External Sphincter Bladder Filling
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