Lepor Herbert, Kaci Ledia, Xue Xiaonan
Department of Urology, New York University School of Medicine, Albert Einstein College of Medicine (XX), New York, New York 10016, USA.
J Urol. 2004 Mar;171(3):1212-5. doi: 10.1097/01.ju.0000110631.81774.9c.
We performed a global self-assessment of continence following radical retropubic prostatectomy (RRP) and determined how this global self-assessment of continence correlates with commonly used definitions of continence.
Between October 2000 and February 2002 all men who underwent RRP were encouraged to complete the University of California-Los Angeles Prostate Cancer Index 3, 6, 12 and 24 months postoperatively. Beginning October 2002 a single question capturing the patient global self-assessment of continence status was added to the postoperative continence assessment. The study design was cross-sectional since only continence surveys submitted between October 2002 through February 2003 were evaluated. Sensitivity, specificity and kappa coefficient was determined for the relationship between the patient global assessment of continence vs the definition of continence based on pad requirement, problem due to incontinence and frequency of incontinence.
Continence progressively improved 3 to 24 months following RRP for all continence outcomes. At 24 months following RRP 97.1% of men considered themselves continent, while 97.1%, 94.1% and 97.1% were considered continent using continence definitions, including the requirement of no or 1 pad in a 24-hour interval, no or slight bother due to incontinence and total control or occasional dribbling, respectively. Our 3 definitions of continence derived from responses to the University of California-Los Angeles Prostate Cancer Index had excellent agreement with patient global self-assessment of continence (kappa coefficients between 0.76 and 0.83).
The majority of men achieve continence without invasive intervention following RRP. Final continence status should be ascertained at 24 months. The patient global assessment of continence provides face validity for other definitions of continence based on responses to validated self-administered questionnaires.
我们对耻骨后根治性前列腺切除术（RRP）后的控尿情况进行了全面的自我评估，并确定这种控尿的全面自我评估与常用的控尿定义之间的相关性。
在2000年10月至2002年2月期间，鼓励所有接受RRP的男性在术后3、6、12和24个月完成加利福尼亚大学洛杉矶分校前列腺癌指数调查。从2002年10月开始，术后控尿评估中增加了一个反映患者对控尿状态全面自我评估的单一问题。该研究设计为横断面研究，因为仅对2002年10月至2003年2月期间提交的控尿调查进行了评估。根据患者对控尿的全面评估与基于尿垫需求、尿失禁问题及尿失禁频率的控尿定义之间的关系，确定了敏感性、特异性和kappa系数。
RRP术后3至24个月，所有控尿结果的控尿情况均逐步改善。RRP术后24个月时，97.1%的男性认为自己控尿良好，而使用控尿定义（包括24小时内无需或仅需1片尿垫、尿失禁无或仅有轻微困扰、完全控制或偶尔滴沥）评估时，分别有97.1%、94.1%和97.1%的男性被认为控尿良好。我们从加利福尼亚大学洛杉矶分校前列腺癌指数的回答中得出的3种控尿定义与患者对控尿的全面自我评估具有极好的一致性（kappa系数在0.76至0.83之间）。
大多数男性在RRP术后无需侵入性干预即可实现控尿。应在术后24个月确定最终的控尿状态。患者对控尿的全面评估为基于有效自填问卷回答的其他控尿定义提供了表面效度。
