Department of Urology, National Hospital Organization Okayama Medical Center, Okayama, Japan.
Investig Clin Urol. 2023 Mar;64(2):168-174. doi: 10.4111/icu.20220380.
The usefulness of the urine loss ratio in the early postoperative period for prognosis of long-term urinary continence after radical prostatectomy has not been fully determined.
All patients who underwent radical prostatectomy for prostate cancer at our institution between November 2015 and March 2021 were retrospectively included. We investigated the rate of continence achievement 1 year after surgery, as well as the associated risk factors for reduced continence achievement, classified by every 10% of the urine loss ratio.
Of the 100 patients with available urine loss ratio data, 66 achieved urinary continence. Ninety-three percent of patients with urine loss ratios of ≤10%, 40%-75% of patients with urine loss ratios of 11%-80%, and 20%-36% of patients with urine loss ratios of >80%, achieved continence. The logistic regression analysis showed that the urine loss ratio severity, body mass index (BMI) of >25 kg/m², and smoking history were unfavorable to achieve urinary continence. A BMI of ≤25 kg/m² was favorable for urinary continence achievement, but only up to an 80% urine loss ratio. Nonsmokers achieved continence well, even with a urine loss ratio of >80%.
Classifying patients into three groups based on their urine loss ratios is potentially useful for urinary continence prognosis. Smoking and obesity were risk factors for continued urinary incontinence, although the prognostic accuracy was expected to improve when considering the severity of the urine loss ratio.
根治性前列腺切除术后早期尿失率对长期尿控预后的作用尚未完全确定。
本研究回顾性纳入 2015 年 11 月至 2021 年 3 月期间在我院接受根治性前列腺切除术治疗前列腺癌的所有患者。我们调查了术后 1 年的控尿率，以及根据尿失率每 10%划分的影响控尿率降低的相关危险因素。
在 100 例具有尿失率数据的患者中，66 例达到尿控。尿失率≤10%、11%-80%、>80%的患者中，分别有 93%、40%-75%、20%-36%达到尿控。逻辑回归分析显示，尿失率严重程度、BMI>25kg/m²和吸烟史不利于达到尿控。BMI≤25kg/m²有利于达到尿控，但仅适用于尿失率<80%的患者。不吸烟的患者即使尿失率>80%也能很好地控制尿失禁。
根据尿失率将患者分为三组，对尿控预后具有潜在的预测价值。尽管考虑到尿失率的严重程度后，预计预测准确性会提高，但吸烟和肥胖是持续性尿失禁的危险因素。
