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[腹腔镜根治性前列腺切除术后的尿失禁:定性分析]

[Urinary continence following laparoscopic radical prostatectomy: qualitative analysis].

作者信息

Erauso A, Perrouin-Verbe M-A, Papin G, Volant A, Doucet L, Joulin V, Deruelle C, Rousseau B, Valeri A, Fournier G

机构信息

Service d'urologie, hôpital de la Cavale Blanche, CHRU de Brest, Brest, France.

出版信息

Prog Urol. 2012 Nov;22(15):945-53. doi: 10.1016/j.purol.2012.07.005. Epub 2012 Sep 5.

Abstract

PURPOSE

The main purpose of this study was to report urinary continence after laparoscopic radical prostatectomy (LRP) for localised prostate cancer and the return to baseline rate for urinary continence. The minor purpose was to determine the risk factors, which influence return to baseline urinary continence after radical prostatectomy.

METHODS

Prospective evaluation of urinary continence with self-administered questionnaire in 300 consecutive LRP for localized prostate cancer.

RESULTS

After LRP, at 3, 6 and 12 months, respectively 12.5%, 23% and 33.7% of patients recover baseline urinary continence. Fifty-four percent, 72.3% and 78.4% of patients did not wear pads 3, 6 and 12 months after LRP. In patients without pad, 43 % recovered baseline continence one year after radical prostatectomy. In univariate analysis, age older than 60 years (P=0.003, P=0.003, P=0.02, 3, 6 and 12 months after LRP) and no sparing of neurovascular bundles (P=0.01, P=0.08 at 3 and 6 months after LRP) were risks factors of urinary incontinence. In multivariate analysis, only age older than 60 years (P=0.018, P=0.01 and P=0.01 at 3, 6 and 12 months after LRP) was a risk factor of urinary incontinence.

CONCLUSION

One year after LRP, 66.3% of patients had urinary incontinence according to our evaluation using stringent criteria, i.e. return to baseline continence status. However, only 21.6% of patients wore pads and less than 2% wore more than two pads per day.

摘要

目的

本研究的主要目的是报告局限性前列腺癌患者行腹腔镜根治性前列腺切除术(LRP)后的尿失禁情况以及尿失禁恢复至基线水平的比例。次要目的是确定影响根治性前列腺切除术后尿失禁恢复至基线水平的危险因素。

方法

采用自行填写问卷的方式对300例连续性局限性前列腺癌患者行LRP后的尿失禁情况进行前瞻性评估。

结果

LRP术后3个月、6个月和12个月时,分别有12.5%、23%和33.7%的患者恢复至基线尿失禁状态。LRP术后3个月、6个月和12个月时,分别有54%、72.3%和78.4%的患者无需使用尿垫。在无需使用尿垫的患者中,43%在根治性前列腺切除术后1年恢复至基线尿失禁状态。单因素分析显示,年龄大于60岁(LRP术后3个月、6个月和12个月时,P分别为0.003、0.003和0.02)以及未保留神经血管束(LRP术后3个月和6个月时,P分别为0.01和0.08)是尿失禁的危险因素。多因素分析显示,只有年龄大于60岁(LRP术后3个月、6个月和12个月时,P分别为0.018、0.01和0.01)是尿失禁的危险因素。

结论

根据我们使用严格标准(即恢复至基线尿失禁状态)进行的评估,LRP术后1年,66.3%的患者存在尿失禁。然而,只有21.6%的患者使用尿垫,且每天使用超过两片尿垫的患者不到2%。

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