From the Department of Obstetrics and Gynecology, Cooper Health, Camden, New Jersey.
Department of Urology.
Female Pelvic Med Reconstr Surg. 2021 Apr 1;27(4):e501-e504. doi: 10.1097/SPV.0000000000000756.
The aim of this study was to identify whether women who undergo a radical cystectomy for uroepithelial carcinoma are at increased risk of pelvic organ prolapse after surgical treatment.
A retrospective cohort study compared female subjects who had undergone a radical cystectomy for uroepithelial carcinoma, as identified through an institutional cancer survivor database, with subjects who presented to the Pelvic Health and Continence Clinic with symptoms of either uterovaginal prolapse or urinary incontinence. Demographic data were collected regarding risk factors for prolapse, and study subjects were asked to complete a Pelvic Organ Prolapse Distress Inventory (POPDI-6). Data were collected through retrospective chart review. The primary outcome is difference in the POPDI-6 between the groups. Statistical evaluation of responses was performed, with analysis of variance used to compare the questionnaire scores between groups and correction for risk factors with χ2 tests, with a P value of 0.05 selected for statistical significance.
There were 36 postcystectomy subjects who responded to the survey, 37 subjects in the prolapse group, and 44 subjects in the incontinence group. With correction for age, body mass index, and number of vaginal deliveries, the postcystectomy group reported significantly lower scores on the POPDI-6 than both the prolapse group (P < 0.0001) and the incontinence group (P = 0.0003).
Radical cystectomy for uroepithelial carcinoma does not correlate with an increased risk of patient-reported symptoms of pelvic organ prolapse.
本研究旨在确定接受根治性膀胱切除术治疗尿路上皮癌的女性在手术后是否有发生盆腔器官脱垂的风险增加。
回顾性队列研究比较了通过机构癌症幸存者数据库确定的接受根治性膀胱切除术治疗尿路上皮癌的女性患者与因子宫阴道脱垂或尿失禁症状就诊于盆腔健康和尿失禁诊所的患者。收集了与脱垂风险因素相关的人口统计学数据，并要求研究对象完成盆腔器官脱垂困扰量表（POPDI-6）。通过回顾性图表审查收集数据。主要结局是两组间 POPDI-6 的差异。对反应进行了统计评估，使用方差分析比较组间问卷评分，并使用 χ2 检验校正风险因素，选择 P 值为 0.05 作为统计学显著性标准。
有 36 名接受膀胱切除术的患者对调查做出了回应，其中 37 名患者在脱垂组，44 名患者在尿失禁组。在矫正年龄、体重指数和阴道分娩次数后，与脱垂组（P < 0.0001）和尿失禁组（P = 0.0003）相比，接受膀胱切除术的患者在 POPDI-6 上的评分明显更低。
根治性膀胱切除术治疗尿路上皮癌与患者报告的盆腔器官脱垂症状风险增加无关。
