Department of Urology, Tokai University School of Medicine, Kanagawa, Japan.
Asian J Endosc Surg. 2024 Jan;17(1):e13243. doi: 10.1111/ases.13243. Epub 2023 Sep 22.
Urinary dysfunctions are common sequelae following prostatectomy. This study aimed to discover factors that can predict urinary continence recovery at various time periods after robot-assisted laparoscopic radical prostatectomy (RARP).
This was a retrospective analysis of data of 419 consecutive patients. Only patients followed up for ≥1 year were enrolled. An answer of "zero pad per day" in the Expanded Prostate Cancer Index Composite urinary assessment (question 5) denoted continence. Possible predictors of urinary continence recovery were evaluated at 3, 3-6, and 6-12 months after the operation.
Continence rates at 3, 6, and 12 months after RARP were 12.9%, 21.2%, and 40.2%, respectively. The proportions of patients using 0-1 pad were 54.2%, 75.7%, and 83.1% at 3, 6, and 12 months after RARP, respectively. Multivariable regression analysis revealed that a membranous urethral length (MUL) ≥11 mm was significantly associated with urinary continence recovery both within 3 months (odds ratio: 0.367, P = .003) and 3-6 months (odds ratio: 0.354, P = .001) after RARP. The analysis also revealed that, in patients with urinary continence at 6 months, a large prostate volume (odds ratio: 1.973, P = .044) and a high body mass index (odds ratio: 2.874, P = .027) were negative predictors of urinary continence recovery within 6-12 months.
A longer MUL was linked to urinary continence recovery within 6 months following RARP, whereas a large prostate volume and a high body mass index were adverse predictors of urinary continence recovery beyond 6 months.
尿功能障碍是前列腺切除术后常见的后遗症。本研究旨在发现可以预测机器人辅助腹腔镜根治性前列腺切除术(RARP)后不同时间段尿控恢复的因素。
这是对 419 例连续患者数据的回顾性分析。仅纳入随访时间≥1 年的患者。在前列腺癌指数综合尿评估的扩展(问题 5)中回答“每天零垫”表示尿控。在手术 3、3-6 和 6-12 个月后评估尿控恢复的可能预测因素。
RARP 后 3、6 和 12 个月的尿控率分别为 12.9%、21.2%和 40.2%。RARP 后 3、6 和 12 个月使用 0-1 个垫的患者比例分别为 54.2%、75.7%和 83.1%。多变量回归分析显示,膜状尿道长度(MUL)≥11mm 与 RARP 后 3 个月内(优势比:0.367,P=0.003)和 3-6 个月内(优势比:0.354,P=0.001)的尿控恢复显著相关。分析还表明,在 6 个月时具有尿控的患者中,大前列腺体积(优势比:1.973,P=0.044)和高体重指数(优势比:2.874,P=0.027)是 6-12 个月内尿控恢复的负预测因素。
MUL 较长与 RARP 后 6 个月内的尿控恢复有关,而前列腺体积大和体重指数高是 6 个月后尿控恢复的不利预测因素。