Can LRP lead to earlier old age incontinence?

[Nik]

I was wondering Dr Krongrad, is it possible even after a good continence recovery post LRP in relatively young man, that later on in old age he could become incontinent more easily than he would have done otherwise?
I realise this question may be somewhat academic, as the chances are most of us would die of cancer if we did not have our diseased prostates removed by then, but I just like to satisfy my inquisitive mind!

[Smith]

I have wondered this myself.....?????????????????????????????

[Arnon Krongrad, MD]

I don't know what "old age incontinence" is. That term is quite general, vague, and undefined, really. We do see incontinence with specific conditions, some of which increase in frequency as we age. A good example is Parkinson's Disease. To frame the question in this context, let us ask: Would LRP increase the likelihood of incontinence as seen with specific age-associated conditions, such as Parkinson's Disease?

First of all, there are no data. So anything we say from this point forward is purely speculative.

Secondly, if LRP increased incontinence with specific conditions, such as Parkinson's Disease, nobody can say by how much. Considering just how virulent are some of these conditions, of which Parkinson's Disease is a perfect example, I cannot imagine that LRP adds much. Put another way, patients can be totally incontinent with specific conditions, such as Parkinson's Disease, even if they never had an LRP, which in this context would seem irrelevant.

Thirdly, if there is a quantifiable increased risk of specific age-associated-condition incontinence with LRP, and this is not at all clear, then to avoid it one would have to bypass the LRP and live with the maladies that LRP did not treat: prostate cancer, severe chronic prostatitis, etc. Would this be a good choice? Because the tradeoff might be living with a condition that in the short term (long before Parkinson's Disease) can cause severe symptoms, including urgency, pain, retention, death, and ... incontinence.

[Nik]

Thanks for making that clear Dr K. I have often thought after a good recovery after LRP done to a high standard, our urinary system would not be much different to a woman's anyway, and they (some of them) only seem to suffer from mild stress incontinence after chilbirth, something we will never have to do....!!!!!

Arnon Krongrad, MD said:

I don't know what "old age incontinence" is. That term is quite general, vague, and undefined, really. We do see incontinence with specific conditions, some of which increase in frequency as we age. A good example is Parkinson's Disease. To frame the question in this context, let us ask: Would LRP increase the likelihood of incontinence as seen with specific age-associated conditions, such as Parkinson's Disease?
First of all, there are no data. So anything we say from this point forward is purely speculative.
Secondly, if LRP increased incontinence with specific conditions, such as Parkinson's Disease, nobody can say by how much. Considering just how virulent are some of these conditions, of which Parkinson's Disease is a perfect example, I cannot imagine that LRP adds much. Put another way, patients can be totally incontinent with specific conditions, such as Parkinson's Disease, even if they never had an LRP, which in this context would seem irrelevant.

Thirdly, if there is a quantifiable increased risk of specific age-associated-condition incontinence with LRP, and this is not at all clear, then to avoid it one would have to bypass the LRP and live with the maladies that LRP did not treat: prostate cancer, severe chronic prostatitis, etc. Would this be a good choice? Because the tradeoff might be living with a condition that in the short term (long before Parkinson's Disease) can cause severe symptoms, including urgency, pain, retention, death, and ... incontinence.