Yamada Yuta, Fujimura Tetsuya, Fukuhara Hiroshi, Sugihara Toru, Miyazaki Hideyo, Nakagawa Tohru, Kume Haruki, Igawa Yasuhiko, Homma Yukio
Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Int J Urol. 2017 Oct;24(10):749-756. doi: 10.1111/iju.13411. Epub 2017 Jul 11.
To investigate predictors of continence outcomes after robot-assisted radical prostatectomy.
Clinical records of 272 patients who underwent robot-assisted radical prostatectomy were investigated. Preoperative Overactive Bladder Symptom Score, International Prostate Symptom Score and clinicopathological factors were investigated, and relationships between factors and recovery of continence after robot-assisted radical prostatectomy were assessed. The presence of overactive bladder was defined as having urgency for more than once a week and having ≥3 points according to the Overactive Bladder Symptom Score.
Age (≤66 years) was significantly associated with continence within 6 months after robot-assisted radical prostatectomy (P = 0.033). The absence of overactive bladder and lower Overactive Bladder Symptom Score (<3) were significantly associated with recovery of continence within 12 months after surgery (both variables P = 0.009). In terms of achieving recovery of continence after robot-assisted radical prostatectomy, Kaplan-Meier curves showed earlier recovery in "age ≤66 years," "prostate weight ≤40 g" and "overactive bladder symptom score <3" (P = 0.0072, 0.0172 and 0.0140, respectively). Multivariate analysis showed that the presence of overactive bladder was an independent negative predictor for recovery of continence within 12 months after surgery (P = 0.019).
The presence of baseline overactive bladder seems to represent an independent negative predictor for recovery of continence at 12 months after robot-assisted radical prostatectomy.
探讨机器人辅助根治性前列腺切除术后控尿结果的预测因素。
对272例行机器人辅助根治性前列腺切除术患者的临床记录进行研究。调查术前膀胱过度活动症症状评分、国际前列腺症状评分及临床病理因素，并评估这些因素与机器人辅助根治性前列腺切除术后控尿恢复之间的关系。膀胱过度活动症的定义为每周尿急次数超过一次且根据膀胱过度活动症症状评分≥3分。
年龄（≤66岁）与机器人辅助根治性前列腺切除术后6个月内的控尿显著相关（P = 0.033）。无膀胱过度活动症及较低的膀胱过度活动症症状评分（<3）与术后12个月内控尿恢复显著相关（两个变量P均 = 0.009）。就机器人辅助根治性前列腺切除术后实现控尿恢复而言，Kaplan-Meier曲线显示“年龄≤66岁”“前列腺重量≤40 g”和“膀胱过度活动症症状评分<3”恢复较早（分别为P = 0.0072、0.0172和0.0140）。多因素分析显示，膀胱过度活动症的存在是术后12个月内控尿恢复的独立负性预测因素（P = 0.019）。
基线膀胱过度活动症的存在似乎是机器人辅助根治性前列腺切除术后12个月控尿恢复的独立负性预测因素。
