Division of Innovative Cancer Therapy, Advanced Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
PLoS One. 2022 Oct 6;17(10):e0275069. doi: 10.1371/journal.pone.0275069. eCollection 2022.
To investigate changes in uroflowmetry parameters in men undergoing robot-assisted radical prostatectomy (RARP) for prostate cancer.
Four hundred and twenty-eight patients received uroflowmetry testing before and after RARP from November 2011 to December 2018. Clinicopathological data, including age, initial prostate-specific antigen (PSA), prostate volume, clinical stage, body mass index (BMI), uroflowmetry parameters, and core lower urinary tract symptom scores (CLSS) were retrospectively obtained from clinical records. Changes in uroflowmetry parameters were analyzed for statistical predictors and effects on post-operative outcomes.
A significant increase in maximum flow rate (MFR) and decreases in voided volume (VV) and post-void residual urine (PVR) were seen. In multivariate analysis, age was a negative predictor of MFR increase, while prostate volume was a positive predictor of PVR decrease and MFR increase. VV decrease led to worse incontinence symptoms, while PVR decrease and MFR increase led to improvement in voiding symptoms such as slow stream and straining. Continence recovery curves showed that VV decrease were associated with a delay in continence recovery.
Significant changes were seen in uroflowmetry results after RARP, each parameter directly related to urinary symptoms. In particular, VV decrease was associated with a worsening of incontinence symptoms and continence recovery.
探讨接受机器人辅助前列腺癌根治术（RARP）的男性患者尿流率参数的变化。
2011 年 11 月至 2018 年 12 月，428 例患者接受了 RARP 前后的尿流率检查。从临床记录中回顾性获取了临床病理数据，包括年龄、初始前列腺特异性抗原（PSA）、前列腺体积、临床分期、体重指数（BMI）、尿流率参数和核心下尿路症状评分（CLSS）。分析了尿流率参数的变化，以寻找统计预测因子及其对术后结果的影响。
最大流量率（MFR）显著增加，而排尿量（VV）和残余尿量（PVR）减少。多元分析显示，年龄是 MFR 增加的负预测因子，而前列腺体积是 PVR 减少和 MFR 增加的正预测因子。VV 减少导致更严重的尿失禁症状，而 PVR 减少和 MFR 增加则改善了排尿症状，如尿流缓慢和用力排尿。控尿恢复曲线显示，VV 减少与控尿恢复延迟有关。
RARP 后尿流率结果发生显著变化，每个参数都与尿路症状直接相关。特别是，VV 减少与尿失禁症状恶化和控尿恢复延迟有关。
