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根治性前列腺切除术后的尿失禁——近100例病例的经验

Urinary incontinence after radical prostatectomy - experience of the last 100 cases.

作者信息

Sosnowski Roman, Szymański Michał, Wolski Jan Karol, Nadolski Tomasz, Kalinowski Tomasz, Demkow Tomasz, Peczkowski Piotr, Pilichowska Małgorzata, Ligaj Marcin, Michalski Wojciech

机构信息

Urooncology Department, Maria Skłodowska Curie, Memorial Cancer Hospital, Warsaw, Poland.

Radiotherapy Department, Maria Sklodowska Curie, Memorial Cancer Hospital, Warsaw, Poland.

出版信息

Cent European J Urol. 2011;64(4):213-7. doi: 10.5173/ceju.2011.04.art5. Epub 2011 Dec 9.

Abstract

Radical prostatectomy (RP) is a recognized treatment method of organ-confined prostate cancer. Among post-surgery complications, urinary incontinence is a major one. The aim of this study was to determine the incontinence rate after RP and to analyze factors that might affect it. Between March 2007 and December 2008, 132 RP's were performed at Warsaw Cancer Center. A questionnaire to assess the condition before and after RP was developed by the authors and sent to all treated patients. The questionnaire focused on health status information, function in urinary domain, rate of returning to "normal" activity level as before RP and satisfaction from the treatment. The median age of patients was 62 years. Out of 132 patients 102 subjects (77.2%) responded to the questionnaire. Of all responders, 35 patients (34.3%) reported total urinary continence after RP. After RP 35(34.3%) patients reported total urinary continence and in 55(53.9%) patients urinary incontinence of medium degree was present. In 12 (11.8%) patients significant urinary incontinence developed. The most common cause of urine dripping (82% of patients with any degree of urinary incontinence) was associated with abdominal muscle pressure. No statistically significant association between urinary incontinence and adjuvant radiotherapy after RP or the surgeon performing the RP was found (>0.79, >0.803). Radical prostatectomy carries a certain risk of complications. We observed an 88.2% rate of significant (total and moderate degree) urinary continence. The adjuvant radiotherapy and surgeons, who performed the RP, did not affect the rate of incontinence.

摘要

根治性前列腺切除术(RP)是公认的治疗局限性前列腺癌的方法。术后并发症中,尿失禁是主要并发症之一。本研究的目的是确定RP术后的尿失禁发生率,并分析可能影响尿失禁的因素。2007年3月至2008年12月期间,华沙癌症中心共进行了132例RP手术。作者设计了一份用于评估RP术前和术后情况的问卷,并发送给所有接受治疗的患者。该问卷聚焦于健康状况信息、泌尿领域功能、恢复到RP术前“正常”活动水平的比例以及对治疗的满意度。患者的中位年龄为62岁。132例患者中有102例(77.2%)回复了问卷。在所有回复者中,35例患者(34.3%)报告RP术后完全尿失禁。RP术后,35例(34.3%)患者报告完全尿失禁,55例(53.9%)患者存在中度尿失禁。12例(11.8%)患者出现严重尿失禁。漏尿的最常见原因(任何程度尿失禁患者中的82%)与腹肌压力有关。未发现尿失禁与RP术后辅助放疗或实施RP的外科医生之间存在统计学显著关联(>0.79,>0.803)。根治性前列腺切除术存在一定的并发症风险。我们观察到严重(完全和中度)尿失禁的发生率为88.2%。辅助放疗和实施RP的外科医生并未影响尿失禁发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df9e/3921751/bd3c2659f385/CEJU-64-00118-g001.jpg

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