年龄和前列腺体积是良性前列腺增生经尿道双极剜除术后短暂性尿失禁的危险因素。

Age and prostate volume are risk factors for transient urinary incontinence after transurethral enucleation with bipolar for benign prostatic hyperplasia.

作者信息

Hirasawa Yosuke, Kato Yuji, Fujita Kiichiro

机构信息

Department of Urology, Tokyo Medical University, Tokyo, Japan.

Department of Urology, Kato Urological Clinic, Saitama, Japan.

出版信息

Int J Urol. 2018 Jan;25(1):76-80. doi: 10.1111/iju.13472. Epub 2017 Oct 3.

DOI:10.1111/iju.13472

PMID:28975723

Abstract

OBJECTIVES

To investigate the predictive factors for transient urinary incontinence after transurethral enucleation with bipolar.

METHODS

We retrospectively analyzed the data of 584 patients who underwent transurethral enucleation with bipolar between December 2011 and September 2016 operated by a single surgeon. Urinary incontinence after transurethral enucleation with bipolar was defined as involuntary leakage of urine that required the use of pads. It was evaluated at 1 week, and 1, 3, 6, 12 and 24 months after transurethral enucleation with bipolar. We defined transient urinary incontinence as urinary incontinence persisting up to 1 month after transurethral enucleation with bipolar. Based on independent risk factors identified by a multivariate stepwise logistic regression analysis, a nomogram to predict transient urinary incontinence was developed.

RESULTS

Of the 584 patients, 17.3%, 13.5%, 3.1%, 0.41%, and 0% patients had urinary incontinence at 1 week, 1, 3, 6 and 12 months after transurethral enucleation with bipolar, respectively. The mean (±standard error) age was 69.6 ± 0.26 years, estimated prostate volume was 54.7 ± 0.91 cm , operative time was 58.0 ± 1.1 min and the prostate specimen weight was 30.6 ± 0.69 g. On univariate analysis, age, prostate volume estimated by transrectal ultrasonography, prostate-specific antigen, prostate specimen weight, operative time, prostate specimen weight/prostate volume and prostate specimen weight/operative time were significant predictive factors for transient urinary incontinence after transurethral enucleation with bipolar. On multivariate analysis, age (hazard ratio 1.07, P-value = 0.0034) and prostate volume (hazard ratio 1.03, P-value < 0.0001) were independent risk factors for transient urinary incontinence after transurethral enucleation with bipolar.

CONCLUSIONS

Age and prostate volume estimated by transrectal ultrasonography seem to represent significant independent risk factors for transient urinary incontinence after transurethral enucleation with bipolar. This should be well discussed with the patient before surgery.

摘要

目的

探讨经尿道双极等离子剜除术后短暂性尿失禁的预测因素。

方法

我们回顾性分析了2011年12月至2016年9月间由单一外科医生实施经尿道双极等离子剜除术的584例患者的数据。经尿道双极等离子剜除术后的尿失禁定义为需要使用尿垫的不自主漏尿。在经尿道双极等离子剜除术后1周、1、3、6、12和24个月对其进行评估。我们将短暂性尿失禁定义为经尿道双极等离子剜除术后持续长达1个月的尿失禁。基于多因素逐步逻辑回归分析确定的独立危险因素，绘制了预测短暂性尿失禁的列线图。

结果

在584例患者中，经尿道双极等离子剜除术后1周、1、3、6和12个月出现尿失禁的患者分别为17.3%、13.5%、3.1%、0.41%和0%。平均（±标准误）年龄为69.6±0.26岁，估计前列腺体积为54.7±0.91cm³，手术时间为58.0±1.1分钟，前列腺标本重量为30.6±0.69g。单因素分析显示，年龄、经直肠超声估计的前列腺体积、前列腺特异性抗原、前列腺标本重量、手术时间、前列腺标本重量/前列腺体积和前列腺标本重量/手术时间是经尿道双极等离子剜除术后短暂性尿失禁的重要预测因素。多因素分析显示，年龄（风险比1.07，P值=0.0034）和前列腺体积（风险比1.03，P值<0.0001）是经尿道双极等离子剜除术后短暂性尿失禁的独立危险因素。