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根治性前列腺切除术后年轻男性的生活质量。

Quality of life in young men after radical prostatectomy.

作者信息

Wright J L, Lin D W, Cowan J E, Carroll P R, Litwin M S

机构信息

Department of Urology, University of Washington School of Medicine, Seattle, WA 98195, USA.

出版信息

Prostate Cancer Prostatic Dis. 2008;11(1):67-73. doi: 10.1038/sj.pcan.4500980. Epub 2007 May 22.

Abstract

Urinary and sexual function and bother are important outcomes following radical prostatectomy (RP). Since urinary and sexual function are age-related, post-operative bother may vary by age. This study explores the disease-specific quality-of-life outcomes in young men compared with older men undergoing RP. Using CaPSURE data, we identified men who underwent RP and completed the UCLA Prostate Cancer Index (PCI) before and 1-year post-RP. Men were stratified by age (< 55 years, 55-64, > or = 65). Multivariate regression models were created: a linear model for predictors of PCI scores and a logistic model for predictors of severe declines in PCI domains. Younger men scored significantly better than older men in urinary function (P=0.04), urinary bother (P=0.02) and sexual function (P<0.0001) 1-year post-RP. Severe declines in urinary bother (odds ratio (OR)=1.54, 1.01-2.35) and sexual function (OR=3.20, 1.97-5.19) were more common in men > or = 65 years. Men with relationships had less urinary bother (P=0.03) and were less likely to experience severe worsening of urinary bother (OR=0.32, 0.17-0.60) while having a greater risk of severe worsening of sexual bother (OR=2.74, 1.28-5.89). The use of sexual aids was associated with worse sexual bother (P<0.0001) and greater risk of severe worsening of sexual bother (OR=2.29, 1.54-3.30). Baseline PCI scores were independent predictors in all models. One year after RP, younger men (age < 55) have similar, or better, urinary and sexual function and bother. Baseline scores are strongly associated with post-RP scores and severity of declines. Current relationships and use of sexual aids have significant roles in post-RP bother.

摘要

根治性前列腺切除术(RP)后,泌尿和性功能以及相关困扰是重要的预后指标。由于泌尿和性功能与年龄相关,术后困扰可能因年龄而异。本研究探讨了与接受RP的老年男性相比,年轻男性特定疾病的生活质量预后情况。利用CaPSURE数据,我们确定了接受RP并在RP前及术后1年完成加州大学洛杉矶分校前列腺癌指数(PCI)的男性。男性按年龄分层(<55岁、55 - 64岁、≥65岁)。创建了多变量回归模型:一个用于PCI评分预测因子的线性模型和一个用于PCI各领域严重下降预测因子的逻辑模型。RP术后1年,年轻男性在泌尿功能(P = 0.04)、泌尿困扰(P = 0.02)和性功能(P < 0.0001)方面的得分显著高于老年男性。在≥65岁的男性中,泌尿困扰(优势比[OR]=1.54,1.01 - 2.35)和性功能(OR = 3.20,1.97 - 5.19)的严重下降更为常见。有伴侣的男性泌尿困扰较少(P = 0.03),且泌尿困扰严重恶化的可能性较小(OR = 0.32,0.17 - 0.60),而性困扰严重恶化的风险较大(OR = 2.74,1.28 - 5.89)。使用性辅助器具与更严重的性困扰相关(P < 0.0001),且性困扰严重恶化的风险更高(OR = 2.29,1.54 - 3.30)。基线PCI评分在所有模型中都是独立的预测因子。RP术后1年,年轻男性(年龄<55岁)的泌尿和性功能以及困扰情况相似或更好。基线评分与RP术后评分及下降严重程度密切相关。当前的伴侣关系和性辅助器具的使用在RP术后困扰中起重要作用。

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