Tienza Antonio, Robles Jose E, Hevia Mateo, Algarra Ruben, Diez-Caballero Fernando, Pascual Juan I
a Department of Urology , Clinica Universidad de Navarra , Pamplona , Spain.
Aging Male. 2018 Mar;21(1):24-30. doi: 10.1080/13685538.2017.1369944. Epub 2017 Aug 31.
To assess prevalence of urinary incontinence (UI) after radical prostatectomy (RP) and to analyze which preoperative characteristics of the patients have influence on UI.
Between 2002 and 2012, 746 consecutive patients underwent RP for clinically localized prostate cancer. We defined UI according to International Continence Society (ICS) definition: "the complaint of any involuntary leakage of urine" after 12 months of recovery, international consultation on incontinence questionnaire (ICIQ-SF) and pads/day was collected too. Clinical features and magnetic resonance imaging measurements were assessed. A multivariable logistic regression model predicting incontinence were built-in after adjust by cofounding factors and bootstrapping.
About 172 (23%) of the patients were classified as incontinent according to the ICS definition. The mean value of the ICIQ-SF was 10.87 (±4). 17.8% of patients use at least one pad/day, 11.9% use more than one pad/day. The preoperative factors independently influential in UI are: age [OR: 1.055; CI 95% (1.006-1.107), p = .028], urethral wall thickness [OR: 5.03; CI 95% (1.11-22.8), p = .036], history of transurethral resection of the prostate [OR: 6.13; CI 95% (1.86-20.18), p = .003] and membranous urethral length [OR: 0.173; CI 95% (0.046-0.64), p = .009]. The predictive accuracy of the model is 78.7% and the area under the curve (AUC) value 71.7%.
Urinary incontinence after radical prostatectomy has different prevalence depending on the definition. Age, prior transurethral resection of the prostate (TURP), membranous urethral length (MUL) and urethral wall thickness (UWT) were risk factors.
评估根治性前列腺切除术后尿失禁（UI）的患病率，并分析患者的哪些术前特征会对尿失禁产生影响。
2002年至2012年间，746例连续患者因临床局限性前列腺癌接受了根治性前列腺切除术。我们根据国际尿失禁学会（ICS）的定义来定义尿失禁：恢复12个月后“任何非自愿性漏尿的主诉”，同时还收集了国际尿失禁咨询问卷（ICIQ-SF）和每日使用尿垫情况。评估临床特征和磁共振成像测量结果。在通过混杂因素调整和自抽样法进行校正后，建立了一个预测尿失禁的多变量逻辑回归模型。
根据ICS定义，约172例（23%）患者被归类为尿失禁。ICIQ-SF的平均值为10.87（±4）。17.8%的患者每天至少使用一个尿垫，11.9%的患者每天使用不止一个尿垫。对尿失禁有独立影响的术前因素包括：年龄[比值比（OR）：1.055；95%置信区间（CI）（1.006 - 1.107），p = 0.028]、尿道壁厚度[OR：5.03；95% CI（1.11 - 22.8），p = 0.036]、经尿道前列腺切除术史[OR：6.13；95% CI（1.86 - 20.18），p = 0.003]和膜部尿道长度[OR：0.173；95% CI（0.046 - 0.64），p = 0.009]。该模型的预测准确率为78.7%，曲线下面积（AUC）值为71.7%。
根据定义不同，根治性前列腺切除术后尿失禁的患病率有所不同。年龄、既往经尿道前列腺切除术（TURP）、膜部尿道长度（MUL）和尿道壁厚度（UWT）是危险因素。
