Urociência; Departamento de Urologia da Universidade Estadual de Campinas - UNICAMP, Campinas, SP, Brasil.
Pontifícia Universidade Católica de Campinas, PUC-Campinas - Campinas, SP, Brasil.
Int Braz J Urol. 2022 May-Jun;48(3):389-396. doi: 10.1590/S1677-5538.IBJU.2021.0632.
To report the prevalence of the definitions used to identify post-prostatectomy incontinence (PPI) after laparoscopic radical prostatectomy (LRP), and to compare the rates of PPI over time under different criteria.
In the period from January 1, 2000, until December 31, 2017, we used a recently described methodology to perform evidence acquisition called reverse systematic review (RSR). The continence definition and rates were evaluated and compared at 1, 3, 6, 12, and >18 months post-operative. Moreover, the RSR showed the "natural history" of PPI after LRP.
We identified 353 review articles in the systematized search, 137 studies about PPI were selected for data collection, and finally were included 203 reports (nr) with 51.436 patients. The most used criterion of continence was No pad (nr=121; 59.6%), the second one was Safety pad (nr=57; 28.1%). A statistically significant difference between continence criteria was identified only at >18 months (p=0.044). From 2013 until the end of our analysis, the Safety pad and Others became the most reported.
RSR revealed the "natural history" of PPI after the LRP technique, and showed that through time the Safety pad concept was mainly used. However, paradoxically, we demonstrated that the two most utilized criteria, Safety pad and No pad, had similar PPI outcomes. Further effort should be made to standardize the PPI denomination to evaluate, compare and discuss the urinary post-operatory function.
报告腹腔镜根治性前列腺切除术（LRP）后识别尿失禁（PPI）的定义的使用情况，并比较不同标准下随时间推移的 PPI 发生率。
在 2000 年 1 月 1 日至 2017 年 12 月 31 日期间，我们使用了一种最近描述的方法来进行证据获取，称为反向系统评价（RSR）。评估和比较了术后 1、3、6、12 和 >18 个月的失禁定义和发生率。此外，RSR 显示了 LRP 后 PPI 的“自然史”。
在系统搜索中我们确定了 353 篇综述文章，选择了 137 篇关于 PPI 的研究进行数据收集，最终纳入了 203 份报告（nr），共 51436 例患者。最常用的失禁标准是无垫（nr=121；59.6%），其次是安全垫（nr=57；28.1%）。仅在 >18 个月时，发现了不同的失禁标准之间存在统计学差异（p=0.044）。从 2013 年到我们分析结束时，安全垫和其他标准成为了最常报道的标准。
RSR 揭示了 LRP 技术后 PPI 的“自然史”，并表明随着时间的推移，安全垫概念主要得到了应用。然而，矛盾的是，我们证明了两种最常用的标准，安全垫和无垫，具有相似的 PPI 结果。应进一步努力使 PPI 名称标准化，以评估、比较和讨论术后尿功能。
