Hoeh Benedikt, Wenzel Mike, Müller Matthias, Wittler Clarissa, Schlenke Eva, Hohenhorst Jan L, Köllermann Jens, Steuber Thomas, Graefen Markus, Tilki Derya, Bernatz Simon, Karakiewicz Pierre I, Preisser Felix, Becker Andreas, Kluth Luis A, Mandel Philipp, Chun Felix K H
Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 60596 Frankfurt am Main, Germany.
Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H4A 3J1, Canada.
Diagnostics (Basel). 2022 Mar 13;12(3):701. doi: 10.3390/diagnostics12030701.
Background: To test the impact of urethral sphincter length (USL) and anatomic variants of prostatic apex (Lee-type classification) in preoperative multiparametric magnet resonance imaging (mpMRI) on mid-term continence in prostate cancer patients treated with radical prostatectomy (RP). Methods: We relied on an institutional tertiary-care database to identify patients who underwent RP between 03/2018 and 12/2019 with preoperative mpMRI and data available on mid-term (>6 months post-surgery) urinary continence, defined as usage 0/1 (-safety) pad/24 h. Univariable and multivariable logistic regression models were fitted to test for predictor status of USL and prostatic apex variants, defined in mpMRI measurements. Results: Of 68 eligible patients, rate of mid-term urinary continence was 81% (n = 55). Median coronal (15.1 vs. 12.5 mm) and sagittal (15.4 vs. 11.1 mm) USL were longer in patients reporting urinary continence in mid-term follow-up (both p < 0.01). No difference was recorded for prostatic apex variants distribution (Lee-type) between continent vs. incontinent patients (p = 0.4). In separate multivariable logistic regression models, coronal (odds ratio (OR): 1.35) and sagittal (OR: 1.67) USL, but not Lee-type, were independent predictors for mid-term continence. Conclusion: USL, but not apex anatomy, in preoperative mpMRI was associated with higher rates of urinary continence at mid-term follow-up.
为了测试术前多参数磁共振成像（mpMRI）中尿道括约肌长度（USL）和前列腺尖部解剖变异（Lee型分类）对接受根治性前列腺切除术（RP）的前列腺癌患者中期尿控的影响。方法：我们依靠一个机构三级医疗数据库来识别在2018年3月至2019年12月期间接受RP且有术前mpMRI以及中期（术后>6个月）尿控数据的患者，尿控定义为24小时使用0/1（-安全）片尿垫。采用单变量和多变量逻辑回归模型来测试在mpMRI测量中定义的USL和前列腺尖部变异的预测状态。结果：在68例符合条件的患者中，中期尿控率为81%（n = 55）。在中期随访中报告尿控的患者，其冠状面（15.1 vs. 12.5 mm）和矢状面（15.4 vs. 11.1 mm）的USL中位数更长（两者p < 0.01）。尿控患者与尿失禁患者之间前列腺尖部变异分布（Lee型）无差异（p = 0.4）。在单独的多变量逻辑回归模型中，冠状面（优势比（OR）：1.35）和矢状面（OR：1.67）的USL，而非Lee型，是中期尿控的独立预测因素。结论：术前mpMRI中的USL而非尖部解剖结构与中期随访时较高的尿控率相关。
