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前列腺钬激光剜除术后短暂性尿失禁的危险因素

Risk Factors for Transient Urinary Incontinence after Holmium Laser Enucleation of the Prostate.

作者信息

Nam Jong Kil, Kim Hyeon Woo, Lee Dong Hoon, Han Ji-Yeon, Lee Jeong Zoo, Park Sung-Woo

机构信息

Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea.

Department of Urology, Pusan National University Hospital, Busan, Korea.

出版信息

World J Mens Health. 2015 Aug;33(2):88-94. doi: 10.5534/wjmh.2015.33.2.88. Epub 2015 Aug 19.

Abstract

PURPOSE

To investigate the factors associated with the occurrence of and recovery from transient urinary incontinence (TUI) after holmium laser enucleation of the prostate (HoLEP).

MATERIALS AND METHODS

From March 2009 to December 2012, 391 consecutive patients treated with HoLEP for benign prostatic hyperplasia were enrolled. Information regarding age, prostate volume, International Prostate Symptom Score, Overactive Bladder Symptom Score, peak urinary flow rate, postvoid residual urine, and operation time was collected. TUI was defined as a patient complaint of urine leakage, regardless of type. Logistic regression was used to investigate the factors associated with the occurrence of TUI, and the Kaplan-Meier test was used to analyze the TUI recovery period.

RESULTS

TUI after HoLEP occurred in 65 patients (16.6%), 52 patients of whom (80.0%) showed recovery within three months. Stress and urge urinary incontinence and postvoid dribbling occurred in 16 patients (4.1%), 29 patients (7.4%), and 33 patients (8.4%), respectively. Age (odds ratio [OR]=3.494; 95% confidence interval [CI]=1.5657.803; p=0.002) and total operation time (OR=3.849; 95% CI=1.6139.185; p=0.002) were factors that significantly affected the occurrence of TUI.

CONCLUSIONS

TUI, defined as any type of urine leakage, occurred after HoLEP in some patients, most of whom recovered within three months. Stress urinary incontinence occurred in only 4% of patients after HoLEP. Age and total operation time were associated with the occurrence of postoperative TUI.

摘要

目的

探讨钬激光前列腺剜除术(HoLEP)后短暂性尿失禁(TUI)发生及恢复的相关因素。

材料与方法

选取2009年3月至2012年12月期间391例因良性前列腺增生接受HoLEP治疗的连续患者。收集患者年龄、前列腺体积、国际前列腺症状评分、膀胱过度活动症症状评分、最大尿流率、残余尿量及手术时间等信息。TUI定义为患者自述有尿液渗漏,不考虑类型。采用逻辑回归分析TUI发生的相关因素,采用Kaplan-Meier检验分析TUI的恢复时间。

结果

65例(16.6%)患者在HoLEP术后发生TUI,其中52例(80.0%)在3个月内恢复。压力性尿失禁、急迫性尿失禁和排尿后滴沥分别发生在16例(4.1%)、29例(7.4%)和33例(8.4%)患者中。年龄(比值比[OR]=3.494;95%置信区间[CI]=1.5657.803;p=0.002)和总手术时间(OR=3.849;95%CI=1.6139.185;p=0.002)是显著影响TUI发生的因素。

结论

定义为任何类型尿液渗漏的TUI在部分HoLEP术后患者中出现,大多数患者在3个月内恢复。HoLEP术后仅4%的患者发生压力性尿失禁。年龄和总手术时间与术后TUI的发生有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/130c/4550601/3f2a68215ccb/wjmh-33-88-g001.jpg

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