Department of Surgery, Duke University Medical Center, Durham, NC, USA.
BJU Int. 2012 Mar;109(6):840-5. doi: 10.1111/j.1464-410X.2011.10423.x. Epub 2011 Aug 22.
There has been a call in the urological literature for standardized reporting of complications. To use strict criteria aiming to report our complications and other postoperative events in a cohort of men undergoing third-generation prostate cryosurgery.
Demographic, clinical and pathological data were collected on men undergoing primary cryosurgery from 2002-2010, excluding those who had received neoadjuvant or adjuvant radiotherapy. Complications and events were broadly defined as any deviation from the expected postoperative course and any subjective complaint expressed during a follow-up visit. Descriptive statistics were generated and compared between groups using chi-squared and rank sum tests as appropriate. Logistic regression analyses were performed to assess the potential predictors of any complication or event.
In total, 106 consecutive patients were identified. There were no intra-operative complications or instances of equipment failure. We observed 42 early complications, with 48 delayed and 10 late postoperative events. A total of five (4.7%) patients had persistent urge and/or stress incontinence. Thirty-one patients had International Prostate Symptom Score (IPSS) and bother index scores available before and after surgery; median scores decreased from 7 and 2 to 6 and 1, for IPSS and bother index, respectively. Twenty-four patients had Sexual Health Inventory for Men scores available before surgery and at 2-year follow-up; median scores decreased from 11 to 2. On multivariate analysis, there were no significant associations.
Modern cryosurgery is safe, and most of the complications and postoperative events are transient. Erectile function, however, has marked deterioration. We were unable to identify significant risk factors for complications or postoperative events.
泌尿科文献中呼吁对并发症进行标准化报告。为了使用严格的标准报告我们在接受第三代前列腺冷冻治疗的男性队列中的并发症和其他术后事件。
收集了 2002 年至 2010 年间接受原发性冷冻治疗的男性的人口统计学、临床和病理数据，排除接受新辅助或辅助放疗的患者。并发症和事件被广泛定义为术后预期过程中的任何偏差以及随访期间表达的任何主观抱怨。使用卡方和秩和检验等适当方法生成描述性统计数据并比较组间差异。进行逻辑回归分析以评估任何并发症或事件的潜在预测因素。
共确定了 106 例连续患者。无术中并发症或设备故障。我们观察到 42 例早期并发症，48 例延迟并发症和 10 例晚期术后事件。共有 5 名（4.7%）患者存在持续性急迫和/或压力性尿失禁。31 名患者在手术前后有国际前列腺症状评分（IPSS）和困扰指数评分；IPSS 和困扰指数的中位数评分分别从 7 和 2 降至 6 和 1。24 名患者在术前和 2 年随访时有男性健康调查（MEN）评分；中位数评分从 11 降至 2。多变量分析无显著相关性。
现代冷冻手术是安全的，大多数并发症和术后事件是短暂的。然而，勃起功能显著恶化。我们无法确定并发症或术后事件的显著危险因素。
