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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.

Many men actually are not bothered by their urinary incontinence but may report some form of incontinence on a survey questionnaire. During the last 10 to 15 years, urinary incontinence rates have . . . [Full Text of this Article]

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