Department of Urology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA.
Department of Urology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA.
Urology. 2020 Jul;141:89-94. doi: 10.1016/j.urology.2020.04.055. Epub 2020 Apr 22.
To assess the incidence of delayed complications after robot-assisted simple prostatectomy and evaluate postoperative lower urinary tract symptoms (LUTS) as a function of time with intermediate-term follow-up.
We retrospectively reviewed 150 patients who underwent robot-assisted simple prostatectomy between May, 2013 and January, 2019. Indication for surgery was bothersome LUTS refractory to medical management and prostate volume ≥80 milliliters. The severity of LUTS was assessed using the International Prostate Symptom Score (IPSS) and quality of life (QOL) score. One-way analysis of variance test with post hoc Tukey's honest significant difference test was used to compare postoperative IPSS and QOL scores as a function of time; P <.05 was considered significant.
At a mean ± SD follow up of 31.3 ± 18.2 months, none of the patients developed a bladder neck contracture and none of the patients required reoperation for LUTS. Postoperatively, IPSS and QOL scores decreased with an increasing duration of follow up (P <.001). Mean IPSS and QOL scores improved between 2 weeks and 3 months postoperatively (P = .027 and P = .006, respectively). After 3 months postoperatively, mean IPPS and QOL scores stabilized and remained unchanged up to 36 months of follow-up (all P >.05).
Robotic simple prostatectomy is associated with a low incidence of delayed complications at a mean of 31.3 months postoperatively. After robotic simple prostatectomy, urinary function outcomes improve in the early postoperative period with maximal improvement occurring at 3 months. Excellent urinary function outcomes are durable up to at least 36 months postoperatively.
评估机器人辅助单纯前列腺切除术(RASP)后迟发性并发症的发生率,并在中期随访的基础上评估术后下尿路症状(LUTS)随时间的变化情况。
我们回顾性分析了 2013 年 5 月至 2019 年 1 月期间接受 RASP 的 150 例患者。手术指征为药物治疗无效的令人困扰的 LUTS 和前列腺体积≥80 毫升。LUTS 的严重程度采用国际前列腺症状评分(IPSS)和生活质量(QOL)评分进行评估。采用单因素方差分析,组间比较采用 Tukey 事后检验,P<0.05 为差异有统计学意义。
平均随访时间为 31.3±18.2 个月,所有患者均未发生膀胱颈挛缩,也无患者因 LUTS 再次手术。术后,随着随访时间的延长,IPSS 和 QOL 评分逐渐降低(P<0.001)。术后 2 周至 3 个月时,IPSS 和 QOL 评分改善(P=0.027 和 P=0.006)。术后 3 个月后,IPSS 和 QOL 评分稳定,直至 36 个月随访时无变化(均 P>0.05)。
在平均 31.3 个月的随访中,RASP 术后迟发性并发症发生率较低。在 RASP 后,术后早期尿功能会有所改善,3 个月时改善最大。术后至少 36 个月时,尿功能效果持久。