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根治性前列腺切除术后尿失禁的简单可靠预测指标:拔除导尿管后尿失禁率的系列测量

Simple and reliable predictor of urinary continence after radical prostatectomy: serial measurement of urine loss ratio after catheter removal.

作者信息

Sato Yoshikazu, Tanda Hitoshi, Nakajima Hisao, Nitta Toshikazu, Akagashi Keigo, Hanzawa Tatsuo, Tobe Musashi, Haga Kazunori, Uchida Kosuke, Honma Ichiya

机构信息

Department of Urology, Sanjukai Hospital, Sapporo, Japan.

出版信息

Int J Urol. 2014 Jul;21(7):647-51. doi: 10.1111/iju.12400. Epub 2014 Feb 24.

Abstract

OBJECTIVES

To evaluate urine loss ratio after catheter removal as a predictive factor of urinary continence after radical prostatectomy.

METHODS

A total of 190 patients who had undergone retropubic radical prostatectomy were evaluated. Urine loss ratio was measured using the 24-h pad test during 7 consecutive days after removal of urethral catheters. Continence rates at 1, 3, 6 and 12 months after operation were evaluated with the urinary function domain of the University of California, Los Angeles Prostate Cancer Index. The desirable urine loss ratio for continent condition at 12 months after the operation was calculated. As desirable target urine loss ratio continence at 12 months was determined by using logistic analysis.

RESULTS

Continence rates of all patients at 1, 3, 6 and 12 months after surgery were 13%, 37.8%, 58.9%, and 85.8%, respectively. Continence rates of patients who achieved ≤1% of urine loss ratio within 7 days or ≤5% urine loss ratio within 3 days after catheter removal was 100% at 12 months. Logistic regression analysis proved these urine loss ratio values were significant predictors of continence at 12 months.

CONCLUSIONS

Urine loss ratio after catheter removal within 7 days is a significant determinant of urinary continence after radical prostatectomy. This parameter could have clinical usefulness to estimate future recovery of urinary continence.

摘要

目的

评估拔除导尿管后的尿失禁率作为根治性前列腺切除术后尿失禁预测因素的价值。

方法

对190例行耻骨后根治性前列腺切除术的患者进行评估。在拔除尿道导尿管后的连续7天内,采用24小时尿垫试验测量尿失禁率。使用加州大学洛杉矶分校前列腺癌指数的尿功能领域评估术后1、3、6和12个月时的控尿率。计算术后12个月时实现控尿状态所需的理想尿失禁率。通过逻辑分析确定术后12个月时作为理想目标尿失禁率的控尿情况。

结果

所有患者术后1、3、6和12个月时的控尿率分别为13%、37.8%、58.9%和85.8%。拔除导尿管后7天内尿失禁率≤1%或3天内尿失禁率≤5%的患者在12个月时的控尿率为100%。逻辑回归分析证明,这些尿失禁率值是12个月时控尿情况的显著预测指标。

结论

拔除导尿管后7天内的尿失禁率是根治性前列腺切除术后尿失禁的重要决定因素。该参数对于估计未来尿失禁的恢复情况可能具有临床应用价值。

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