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磁共振成像测量的尿道长度与机器人辅助根治性前列腺切除术后尿失禁恢复之间的显著关联。

Significant association between urethral length measured by magnetic resonance imaging and urinary continence recovery after robot-assisted radical prostatectomy.

作者信息

Kitamura Kosuke, China Toshiyuki, Kanayama Mayuko, Nagata Masayosi, Isotani Shuji, Wakumoto Yoshiaki, Muto Satoru, Ide Hisamitsu, Horie Shigeo

机构信息

Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan.

Department of Advanced Informatics for Genetic Disease, Juntendo University, Graduate School of Medicine, Tokyo, Japan.

出版信息

Prostate Int. 2019 Jun;7(2):54-59. doi: 10.1016/j.prnil.2018.06.003. Epub 2018 Jun 27.

Abstract

INTRODUCTION

To determine the clinical predictive factors affecting the recovery from postoperative urinary incontinence after robot-assisted radical prostatectomy (RARP).

MATERIALS AND METHODS

We consecutively analyzed 320 patients who underwent RARP between January 2012 and March 2015. The restoration of urinary continence was defined as follows: the use of no pads/no leakage of urine or the use of a safety pad. Preoperative covariates were statistically assessed by multivariate logistic regression analysis to investigate their predict factor to recovery of urinary incontinence. Therefore, in this study, we sought to identify predictors of early urinary continence status in a single-center retrospective study of consecutive patients who underwent RARP.

RESULTS

Continence rates at 1, 3, 6, and 12 months after the catheter was removed were 44%, 71%, 83%, and 93%, respectively. Age, body mass index, and prostate volume had no significant association with urinary continence recovery. In contrast to this, longer preoperative membranous urethral length (MUL) was significantly associated with earlier postoperative continence recovery. Multivariate analysis demonstrated that longer preoperative MUL is significantly associated with continence recovery at 1 month ( = 0.0235).

CONCLUSION

Approximately 70% of patients achieved urinary continence within 3 months after RARP. Multivariate analysis showed that age, body mass index, and prostate volume had no significant association with urinary continence recovery. Preoperative MUL assessed by magnetic resonance imaging was an independent predictor of early recovery from urinary incontinence after RARP.

摘要

引言

确定影响机器人辅助根治性前列腺切除术后尿失禁恢复的临床预测因素。

材料与方法

我们连续分析了2012年1月至2015年3月期间接受机器人辅助根治性前列腺切除术的320例患者。尿失禁的恢复定义如下:不使用尿垫/无尿液漏出或使用安全尿垫。通过多因素逻辑回归分析对术前协变量进行统计学评估,以研究其对尿失禁恢复的预测因素。因此,在本研究中,我们试图在一项对连续接受机器人辅助根治性前列腺切除术患者的单中心回顾性研究中确定早期尿失禁状态的预测因素。

结果

拔除导尿管后1、3、6和12个月时的控尿率分别为44%、71%、83%和93%。年龄、体重指数和前列腺体积与尿失禁恢复无显著相关性。与此相反,术前膜部尿道长度(MUL)较长与术后早期控尿恢复显著相关。多因素分析表明,术前MUL较长与术后1个月控尿恢复显著相关( = 0.0235)。

结论

约70%的患者在机器人辅助根治性前列腺切除术后3个月内实现尿失禁控制。多因素分析表明,年龄、体重指数和前列腺体积与尿失禁恢复无显著相关性。通过磁共振成像评估的术前MUL是机器人辅助根治性前列腺切除术后尿失禁早期恢复的独立预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/adeb/6664308/ae1a4345489d/gr1.jpg

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