Department of Urology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Urologia. 2024 Feb;91(1):141-146. doi: 10.1177/03915603231191269. Epub 2023 Aug 26.
In addition to ensuring cancer control, prevention of incontinence which significantly impact patients' quality of life, is also an important issue in robot-assisted radical prostatectomy (RARP) operations. In this study, we aimed to find the correlation of urinary continence recovery with various factors after Robot assisted radical prostatectomy.
This study included 162 patients treated with RARP with perioperative data and at least 1 year of follow-up. Also, the preoperative, intraoperative, and postoperative parameters of the patients were analyzed. The continence recovery rate in our study was assessed at 6th week, 3rd month, 6th month, 9th month, and 12th month, post-surgery. Logistic regression analysis evaluated the association between the predictive factors and urinary continence recovery in the early and late stages.
The majority of patients with prostate cancer present in sixth decade of life. The majority of our patients (56.7%) were categorized as high risk using D'Amico classification. The continence rate in our study at 6th week, 3rd month, 6th month, 9th month, and 12th month were 40.1%, 72.2%, 85.2%, 89.5%, and 91.4%, respectively. No improvement in continence status was observed after 1 year in our study. There was significant correlation of age with continence status at 6th week, 3rd month, and 6th month. The young age is associated with early recovery of continence. At 3 and 9 months, the non-diabetics cases achieved significantly higher continence rates than diabetics ( < 0.05) which shows that diabetes causes delay in attainment of continence.
The young age may be associated with early recovery of continence, but further validation requires large number of cases. We attributed good continence recovery rate to meticulous dissection and preservation of good urethral length.
除了控制癌症外,预防对患者生活质量有重大影响的尿失禁也是机器人辅助前列腺根治性切除术(RARP)的重要问题。本研究旨在探讨机器人辅助前列腺根治性切除术后尿控恢复与多种因素的相关性。
本研究纳入了 162 例接受 RARP 治疗的患者,收集了他们围手术期的数据和至少 1 年的随访结果。分析了患者的术前、术中、术后参数。术后第 6 周、第 3 个月、第 6 个月、第 9 个月和第 12 个月评估患者的控尿恢复率。采用 logistic 回归分析评估预测因素与早期和晚期尿控恢复的关系。
大多数前列腺癌患者处于 60 岁左右。根据 D'Amico 分类,我们的大多数患者(56.7%)为高危患者。我们的研究中,术后第 6 周、第 3 个月、第 6 个月、第 9 个月和第 12 个月的控尿率分别为 40.1%、72.2%、85.2%、89.5%和 91.4%。本研究中,1 年后控尿状态无改善。年龄与术后第 6 周、第 3 个月和第 6 个月的控尿状态显著相关。年轻的年龄与控尿的早期恢复有关。在 3 个月和 9 个月时,非糖尿病患者的控尿率明显高于糖尿病患者(<0.05),这表明糖尿病导致控尿的延迟。
年轻的年龄可能与早期控尿恢复有关,但需要更多的病例进一步验证。我们认为良好的控尿恢复率与精细的解剖和良好的尿道长度保存有关。