Department of Urology, Peking University First Hospital and Institute of Urology, National Research Center for Genitourinary Oncology, Beijing, China.
Department of Urology, Peking University First Hospital and Institute of Urology, National Research Center for Genitourinary Oncology, Beijing, China.
Kaohsiung J Med Sci. 2018 Mar;34(3):172-178. doi: 10.1016/j.kjms.2017.08.008. Epub 2017 Sep 29.
We aim to develop a nomogram to predict re-operation due to secondary hemorrhage after Monopolar transurethral resection of the prostate (M-TURP). We identified patients undergoing M-TURP at Peking University First Hospital from 2000 to 2013. Univariate and multivariate logistic regression models were developed to predict the occurrence re-operation due to secondary hemorrhage. The discriminatory ability of the nomogram was tested using the area under the receiver operating characteristic curve (ROC), and internal validation was performed via bootstrap resampling. Of the 1901 patients who underwent M-TURP during the study period, 9.1% (173 patients) experienced hemorrhage after M-TURP, and they had a 22.0% re-operation rate (38 patients). Benign prostatic hyperplasia (BPH)-related complications (odds ratio, 0.386; 95% CI, 0.177-0.841), percent of resected prostate (OR, 0.156; 95% CI, 0.023-1.060) and suprapubic cystostomy (OR, 0.298; 95% CI, 0.101-0.881) were independently associated with re-operation. The nomogram accurately predicted re-operation (area under the ROC curve 0.718). The negative predictive value was 88.0%, while the positive predictive value was 47.9%. Re-operation due to secondary hemorrhage after M-TURP was associated with no BPH-related complications, lower percent of resected prostate and no suprapubic cystostomy and was accurately predicted with using the nomogram.
我们旨在开发一个列线图模型，以预测经尿道前列腺单极切除术（M-TURP）后因继发性出血而再次手术的可能性。我们从 2000 年至 2013 年在北京大学第一医院识别出接受 M-TURP 的患者。使用单变量和多变量逻辑回归模型来预测因继发性出血而再次手术的发生。通过接受者操作特征曲线（ROC）下的面积来测试列线图的区分能力，并通过自举重采样进行内部验证。在研究期间接受 M-TURP 的 1901 例患者中，9.1%（173 例）发生 M-TURP 后出血，其中 22.0%（38 例）需要再次手术。良性前列腺增生（BPH）相关并发症（比值比，0.386；95%置信区间，0.177-0.841）、切除前列腺的百分比（OR，0.156；95%置信区间，0.023-1.060）和耻骨上膀胱造口术（OR，0.298；95%置信区间，0.101-0.881）与再次手术独立相关。该列线图能准确预测再次手术（ROC 曲线下面积 0.718）。阴性预测值为 88.0%，而阳性预测值为 47.9%。M-TURP 后因继发性出血而再次手术与无 BPH 相关并发症、较低的前列腺切除百分比和无耻骨上膀胱造口术相关，并且可以使用该列线图准确预测。
