Nishikawa Masatomo, Watanabe Hiromitsu, Kurahashi Toshifumi
Department of Urology, Seirei Mikatabara Hospital, Hamamatsu, Japan.
Int J Urol. 2017 Sep;24(9):692-697. doi: 10.1111/iju.13406. Epub 2017 Jul 7.
To evaluate the impact of metabolic syndrome on the early recovery of urinary continence after robot-assisted radical prostatectomy.
The present study included a total of 302 consecutive Japanese patients with clinically localized prostate cancer who underwent robot-assisted radical prostatectomy. In this study, postoperative urinary continence was defined as no leak or the use of a security pad. The continence status was assessed by interviews before and 1 and 3 months after robot-assisted radical prostatectomy. Metabolic syndrome was defined as follows: body mass index ≥25 kg/m and two or more of the following: hypertension, diabetes mellitus and dyslipidemia. The effect of the presence of metabolic syndrome on the continence status of these patients was retrospectively examined.
A total of 116 (38.4%) and 203 (67.2%) of the 302 patients were continent at 1 and 3 months after robot-assisted radical prostatectomy, respectively. A total of 31 (10.3%) patients were judged to have metabolic syndrome. Despite the operative time being longer in patients with metabolic syndrome, no significant differences were observed in the remaining preoperative, intraoperative or postoperative variables between patients with or without metabolic syndrome. On multivariate logistic regression analysis, metabolic syndrome and the duration of hospitalization were significantly correlated with the 1-month continence status. Similarly, metabolic syndrome and estimated blood loss during surgery were independent predictors of continence rates at 3 months after robot-assisted radical prostatectomy.
These findings suggest that the presence of metabolic syndrome could have a significant impact on the early recovery of urinary continence after robot-assisted radical prostatectomy.
评估代谢综合征对机器人辅助根治性前列腺切除术后早期尿失禁恢复的影响。
本研究共纳入302例连续的临床局限性前列腺癌日本患者,他们均接受了机器人辅助根治性前列腺切除术。在本研究中,术后尿失禁定义为无漏尿或使用安全垫。通过在机器人辅助根治性前列腺切除术前、术后1个月和3个月进行访谈来评估尿失禁状态。代谢综合征的定义如下:体重指数≥25 kg/m²,且伴有以下两种或更多情况:高血压、糖尿病和血脂异常。回顾性研究代谢综合征的存在对这些患者尿失禁状态的影响。
302例患者中,分别有116例(38.4%)和203例(67.2%)在机器人辅助根治性前列腺切除术后1个月和3个月时实现控尿。共有31例(10.3%)患者被判定患有代谢综合征。尽管代谢综合征患者的手术时间较长,但在有无代谢综合征的患者之间,其余术前、术中和术后变量均未观察到显著差异。多因素逻辑回归分析显示,代谢综合征和住院时间与1个月时的控尿状态显著相关。同样,代谢综合征和手术期间估计失血量是机器人辅助根治性前列腺切除术后3个月控尿率的独立预测因素。
这些发现表明,代谢综合征的存在可能对机器人辅助根治性前列腺切除术后早期尿失禁的恢复产生显著影响。