Huang Jian-lin, Qiu Min, Ma Lu-lin
Department of Urology, Peking University Third Hospital, Beijing, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2013 Jun 18;45(3):499-503.
Radical prostatectomy is one of the most effective treatments for men with clinically localized prostate cancer. Though technical innovations,especially laparoscopic techniques,have developed rapidly for the last decade, urinary incontinence remains one of the most troubling side effects of the operation. While the injury of urethral sphincter and its innervations was considered as the most important reason for incontinence, factors influencing postoperative continence that have been considered include clinical features of patients, such as the patient's age, size of the prostate, prior prostatic surgery and features of the surgical technique itself, such as preservation of full functional-length urethra, preservation of the neurovascular bundles, bladder neck preservation or reconstruction and pelvic floor muscle training during the early phase after the surgery. Nonetheless, many factors above have not been clearly established, and controversy goes on among different studies. This article reviews factors that may influence urinary continence after laparoscopic radical prostatectomy.
根治性前列腺切除术是治疗临床局限性前列腺癌男性患者最有效的方法之一。尽管在过去十年中,技术创新尤其是腹腔镜技术发展迅速,但尿失禁仍然是该手术最令人困扰的副作用之一。虽然尿道括约肌及其神经支配的损伤被认为是尿失禁的最重要原因,但已被考虑的影响术后控尿的因素包括患者的临床特征,如患者年龄、前列腺大小、既往前列腺手术史,以及手术技术本身的特征,如保留全功能长度尿道、保留神经血管束、保留或重建膀胱颈以及术后早期的盆底肌肉训练。尽管如此,上述许多因素尚未明确,不同研究之间仍存在争议。本文综述了可能影响腹腔镜根治性前列腺切除术后尿失禁的因素。