Department of Urology, University of California Irvine Medical Center, Orange, Los Angeles, CA, USA.
BJU Int. 2011 Nov;108(9):1492-6. doi: 10.1111/j.1464-410X.2010.10015.x. Epub 2011 Jan 18.
• To evaluate associations between baseline characteristics, nerve-sparing (NS) status and return of continence, as a relationship may exist between return to continence and preservation of the neurovascular bundles for potency during radical prostatectomy (RP).
• The study included 592 consecutive robotic RPs completed between 2002 and 2007. • All data were entered prospectively into an electronic database. • Continence data (defined as zero pads) was collected using self-administered validated questionnaires. • Baseline characteristics (age, International Index of Erectile Function [IIEF-5] score, American Urological Association symptom score, body mass index [BMI], clinical T-stage, Gleason score, and prostate-specific antigen level), NS status and learning curve were retrospectively evaluated for association with overall continence at 1, 3 and 12 months after RP using univariate and multivariable methods. • Any patient taking preoperative phosphodiesterase inhibitors was excluded from the postoperative analysis.
• Complete data were available for 537 of 592 patients (91%). • Continence rates at 12 months after RP were 89.2%, 88.9% and 84.8% for bilateral NS, unilateral NS and non-NS respectively (P= 0.56). • In multivariable analysis age, IIEF-5 score and BMI were significant independent predictors of continence. • CavernosalNS status did not significantly affect continence after adjusting for other co-variables.
• After careful multivariable analysis of baseline characteristics age, IIEF-5 score and BMI affected continence in a statistically significant fashion. This suggests that baseline factors and not the physical preservation of the cavernosal nerves predict overall return to continence.
评估基线特征、神经保留（NS）状态与恢复尿控之间的关系，因为在根治性前列腺切除术（RP）中，恢复尿控与保留神经血管束以维持勃起功能之间可能存在关联。
研究纳入了 2002 年至 2007 年间完成的 592 例连续机器人 RP。所有数据均前瞻性地输入电子数据库。通过自我管理的验证问卷收集尿控数据（定义为零垫）。基线特征（年龄、国际勃起功能指数[IIEF-5]评分、美国泌尿外科学会症状评分、体重指数[BMI]、临床 T 分期、Gleason 评分和前列腺特异性抗原水平）、NS 状态和学习曲线与 RP 后 1、3 和 12 个月的总体尿控进行了回顾性评估，使用单变量和多变量方法。任何术前服用磷酸二酯酶抑制剂的患者均被排除在术后分析之外。
592 例患者中有 537 例（91%）完整数据可用。RP 后 12 个月的尿控率分别为双侧 NS 组 89.2%、单侧 NS 组 88.9%和非 NS 组 84.8%（P=0.56）。多变量分析显示，年龄、IIEF-5 评分和 BMI 是尿控的独立预测因素。在调整其他协变量后，海绵体 NS 状态对尿控无显著影响。
经过仔细的多变量分析，基线特征（年龄、IIEF-5 评分和 BMI）以统计学显著的方式影响尿控。这表明，是基线因素而不是海绵体神经的物理保留预测了总体尿控的恢复。
