Walsh P C, Marschke P, Ricker D, Burnett A L
James Buchanan Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Urology. 2000 Jan;55(1):58-61. doi: 10.1016/s0090-4295(99)00397-0.
After radical prostatectomy, the rates for recovery of urinary continence and sexual function reported by experienced surgeons are much higher than the patient-reported outcomes from other centers. It is uncertain whether this represents differences in surgical technique or in the collection of data. This study was performed to determine patient-reported rates of continence and potency after radical prostatectomy performed by an experienced surgeon at a high-volume referral center for the treatment of localized prostate cancer.
Sixty-four men with localized prostate cancer who were potent preoperatively and who had sexual partners underwent anatomic radical prostatectomy between March 1997 and January 1998. A validated disease-targeted quality-of-life survey that assesses function and bother in two organ systems (urinary and sexual) was administered preoperatively and at 3, 6, 12, and 18 months postoperatively.
Urinary continence, which was defined as wearing no pads, gradually improved during the first 12 months after surgery, and at 1 2 and 18 months, 93% of the patients were dry. Throughout the study, 93% to 98% of the patients characterized their urinary bother as none or small. Potency, defined as the ability to have unassisted intercourse with or without the use of sildenafil, improved gradually, and by 18 months, 86% of patients were potent and 84% considered sexual bother as none or small. Although one third of patients at 18 months were using sildenafil intermittently, only 2 patients were not able to have intercourse without its use.
Patient-reported rates of continence and potency after radical prostatectomy performed by an experienced surgeon are high.
根治性前列腺切除术后，经验丰富的外科医生报告的尿失禁和性功能恢复率远高于其他中心患者报告的结果。目前尚不确定这是手术技术差异还是数据收集方式不同所致。本研究旨在确定在一家治疗局限性前列腺癌的高容量转诊中心，由经验丰富的外科医生进行根治性前列腺切除术后患者报告的尿失禁和性功能恢复率。
1997年3月至1998年1月期间，64例术前性功能正常且有性伴侣的局限性前列腺癌男性接受了解剖性根治性前列腺切除术。术前以及术后3、6、12和18个月，对患者进行了一项经过验证的针对疾病的生活质量调查，该调查评估两个器官系统（泌尿和性）的功能及困扰程度。
尿失禁定义为无需使用尿垫，术后前12个月逐渐改善，在12个月和18个月时，93%的患者无需使用尿垫。在整个研究过程中，93%至98%的患者表示泌尿方面的困扰不存在或轻微。性功能定义为无需使用西地那非或使用西地那非辅助下能够进行性交，性功能逐渐改善，到18个月时，86%的患者性功能正常，84%的患者认为性方面的困扰不存在或轻微。虽然18个月时三分之一的患者在间歇性使用西地那非，但只有2例患者在不使用该药的情况下无法进行性交。
由经验丰富的外科医生进行根治性前列腺切除术后，患者报告的尿失禁和性功能恢复率较高。
