Department of General Practice, National University of Ireland, Galway, Ireland.
Neurourol Urodyn. 2012 Apr;31(4):465-9. doi: 10.1002/nau.21231. Epub 2012 Mar 6.
The impact of urinary incontinence (UI) on health-related quality of life (HRQoL) has been less well researched in men than women and the general population. This study aims to assess the association between UI and HRQoL in men 1 year after prostate surgery.
Planned secondary analysis of data from two parallel randomized controlled trials of active conservative treatment for UI in 853 men following radical prostatectomy (RP) and transurethral resection of the prostate (TURP). Men of any age were eligible for trial inclusion if they were experiencing UI 6 weeks after undergoing RP or TURP at 34 centers in the United Kingdom. Univariate and multivariate analysis considered associations between health status (SF-12 and EQ-5D) and self-reported UI. Multivariate analysis controlled for age, obesity, UI prior to surgery, and concomitant fecal incontinence.
Mean age of 411 men in the RP trial was 62.3 years (SD 5.7) and 442 men in the TURP trial was 68.0 (SD 7.9). Of men with UI at 6 weeks after surgery, 76.7% in the RP group and 63.2% in the TURP group still had UI at 12 months. Any UI at 12 months was significantly associated with reduced HRQoL in the RP group and lower EQ-5D and SF-12 Mental Component Scores in the TURP group.
Any UI is a significant factor in reduced HRQoL in men following prostate surgery, particularly younger men who undergo RP. Its importance to patients as an adverse outcome should not be underestimated.
与女性和普通人群相比,男性尿失禁(UI)对健康相关生活质量(HRQoL)的影响研究较少。本研究旨在评估前列腺手术后 1 年内男性 UI 与 HRQoL 之间的关系。
对两项平行的随机对照试验数据进行计划的二次分析,这些试验针对根治性前列腺切除术(RP)和经尿道前列腺切除术(TURP)后 853 例男性的积极保守治疗进行 UI。如果男性在英国 34 个中心接受 RP 或 TURP 后 6 周出现 UI,且年龄不限,则有资格参加试验。单变量和多变量分析考虑了健康状况(SF-12 和 EQ-5D)与自我报告的 UI 之间的关联。多变量分析控制了年龄、肥胖、手术前的 UI 和同时存在的粪便失禁。
RP 试验中 411 名男性的平均年龄为 62.3 岁(SD 5.7),TURP 试验中 442 名男性的平均年龄为 68.0 岁(SD 7.9)。在手术后 6 周出现 UI 的男性中,RP 组中有 76.7%和 TURP 组中有 63.2%在 12 个月时仍有 UI。RP 组中任何 UI 在 12 个月时与 HRQoL 降低显著相关,TURP 组中 EQ-5D 和 SF-12 心理成分评分较低。
在前列腺手术后,任何 UI 都是男性 HRQoL 降低的重要因素,尤其是接受 RP 的年轻男性。其作为不良后果对患者的重要性不应低估。