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耻骨后根治性前列腺切除术后的发病率及生活质量

[Morbidity and quality of life following radical retropubic prostatectomy].

作者信息

Stene Jan Boris, Angelsen Anders

机构信息

Institutt for kreftforskning og molekylaer medisin, Det medisinske fakultet, Norges teknisk-naturvitenskapelige universitet.

出版信息

Tidsskr Nor Laegeforen. 2003 Jun 12;123(12):1657-9.

Abstract

BACKGROUND

Radical retropubic prostatectomy is associated with urinary incontinence and erectile dysfunction. The purpose of this study is to evaluate postoperatively the quality of life of these patients as well as the occurrence of urinary incontinence and erectile dysfunction. MATERIAL OG METHODS: 159 patients operated with radical retropubic prostatectomy between 1996 and 2000 were asked to fill in a questionnaire in order to evaluate their quality of life after the procedure; the response rate was 82 %. This information was compared to preoperative as well as histopathological data.

RESULTS

55 % of the patients with normal erection before operation had an erection that allowed intercourse at the time they answered the questionnaire, irrespective of whether or not they were using aids. 82 % were urinary continent. In 1997, 23 % of the patients experienced urinary incontinence and 49 % reported erectile dysfunction. In 1999 the corresponding results were 9 % and 38 %. Patients with urinary incontinence, pT3 tumour, positive tumour margins, or elevated postoperative serum prostate-specific antigen (PSA) reported reduced quality of life. 94 % of the patients reported that they would probably have chosen the same treatment again.

INTERPRETATION

Patients operated in 1999 reported a statistically significant better quality of life compared to patients operated in 1997. This is an indication of the importance of training and experience with radical retropubic prostatectomy. Reduced quality of life is related to urinary incontinence and the presence of pT3 tumour, positive tumour margins and serum prostate-specific antigen.

摘要

背景

耻骨后根治性前列腺切除术与尿失禁和勃起功能障碍相关。本研究旨在术后评估这些患者的生活质量以及尿失禁和勃起功能障碍的发生率。材料与方法:1996年至2000年间接受耻骨后根治性前列腺切除术的159例患者被要求填写一份问卷,以评估术后的生活质量;回复率为82%。将这些信息与术前以及组织病理学数据进行比较。

结果

术前勃起功能正常的患者中,55%在回答问卷时勃起功能可进行性交,无论他们是否使用辅助器具。82%的患者无尿失禁。1997年,23%的患者出现尿失禁,49%的患者报告有勃起功能障碍。1999年相应的结果分别为9%和38%。有尿失禁、pT3期肿瘤、肿瘤切缘阳性或术后血清前列腺特异性抗原(PSA)升高的患者报告生活质量下降。94%的患者报告他们可能会再次选择相同的治疗方法。

解读

与1997年接受手术的患者相比,1999年接受手术的患者报告的生活质量在统计学上有显著改善。这表明耻骨后根治性前列腺切除术的培训和经验很重要。生活质量下降与尿失禁以及pT3期肿瘤、肿瘤切缘阳性和血清前列腺特异性抗原的存在有关。

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