Department of Rehabilitation, Jyoban Hospital of Tokiwa Foundation, Iwaki 972-8322, Japan.
Department of Urology, Jyoban Hospital of Tokiwa Foundation, Iwaki 972-8322, Japan.
Int J Environ Res Public Health. 2023 Feb 24;20(5):4085. doi: 10.3390/ijerph20054085.
Post-operative urinary incontinence (PUI) after robotic-assisted radical prostatectomy (RARP) is an important complication; PUI occurs immediately after postoperative urethral catheter removal, and, although approximately 90% of patients improve within one year after surgery, it can significantly worsen their quality of life. However, information is lacking on its nature in community hospital settings, particularly in Asian countries. The purposes of this study were to investigate the time required to recover from PUI after RARP and to identify its associated factors in a Japanese community hospital.
Data were extracted from the medical records of 214 men with prostate cancer who underwent RARP from 2019 to 2021. We then calculated the number of days elapsed from the surgery to the initial outpatient visit confirming PUI recovery among the patients. We estimated the PUI recovery rate using the Kaplan-Meier product limit method and evaluated associated factors using the multivariable Cox proportional hazards model.
The PUI recovery rates were 5.7%, 23.4%, 64.6%, and 93.3% at 30, 90, 180, and 365 days following RARP, respectively. After an adjustment, those with preoperative urinary incontinence experienced significantly slower PUI recovery than their counterparts, while those with bilateral nerve sparing experienced recovery significantly sooner than those with no nerve sparing.
Most PUI improved within one year, but a proportion of those experiencing recovery before 90 days was smaller than previously reported.
机器人辅助根治性前列腺切除术（RARP）后尿失禁（PUI）是一种重要的并发症；PUI 发生在术后尿道导管拔除后立即发生，尽管大约 90%的患者在手术后一年内会有所改善，但它会显著降低他们的生活质量。然而，关于社区医院环境中 PUI 性质的信息尚缺乏，特别是在亚洲国家。本研究的目的是调查 RARP 后 PUI 恢复所需的时间，并在日本社区医院确定其相关因素。
从 2019 年至 2021 年接受 RARP 的 214 名前列腺癌男性患者的病历中提取数据。然后，我们计算了从手术到首次门诊就诊确认 PUI 恢复的天数。我们使用 Kaplan-Meier 乘积限法估计 PUI 恢复率，并使用多变量 Cox 比例风险模型评估相关因素。
RARP 后 30、90、180 和 365 天的 PUI 恢复率分别为 5.7%、23.4%、64.6%和 93.3%。调整后，术前有尿失禁的患者 PUI 恢复明显较慢，而双侧神经保留的患者恢复明显较快，无神经保留的患者恢复较慢。
大多数 PUI 在一年内得到改善，但在 90 天内恢复的比例比之前报道的要小。
