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经尿道前列腺电切术后良性前列腺增生患者术前尿动力学参数对临床结果的影响。

The influence of preoperative urodynamic parameters on clinical results in patients with benign prostatic hyperplasia after transurethral resection of the prostate.

机构信息

Urology Department, The Second Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China.

出版信息

World J Urol. 2023 Dec;41(12):3679-3685. doi: 10.1007/s00345-023-04656-w. Epub 2023 Oct 20.

Abstract

PURPOSE

To identify the urodynamic parameters affecting the clinical outcomes of transurethral resection of the prostate(TURP) surgery for patients with benign prostatic hyperplasia(BPH) by multifactor analysis and establish a regression model with diagnostic values.

METHODS

The medical records of patients who underwent TURP surgery for BPH between December 2018 and September 2021 were collected from the urology department of the Second Affiliated Hospital of Kunming Medical University, Kunming, China. The patients' clinical data and urodynamic parameters were collected before surgery. The urodynamic parameters affecting surgical efficacy were identified by multifactor analysis, and a regression model with diagnostic values was established and evaluated.

RESULTS

A total of 201 patients underwent TURP, of whom 144 had complete preoperative urodynamic data. Each urodynamic factor was subjected to multifactor analysis, and the bladder contractility index (BCI), bladder outflow obstruction index (BOOI), bladder residual urine, and bladder compliance (BC) were found to be independent influence factors on the efficacy of TURP in patients with BPH. The diagnostic value of the regression model was analyzed by receiver operating characteristics (ROC) analysis, and it was found that the AUC = 0.939 (95% CI 0.886-0.972), for which the sensitivity and specificity were 95.19% and 80%, respectively.

CONCLUSIONS

The regression model had high diagnostic sensitivity and specificity in predicting the efficacy of surgery, and the diagnostic value was higher than that of individual urodynamic factors. Therefore, BCI, BOOI, bladder residual urine, and BC should be considered as independent influence factors on the efficacy of TURP surgery for BPH.

摘要

目的

通过多因素分析确定影响经尿道前列腺切除术(TURP)治疗良性前列腺增生(BPH)患者临床疗效的尿动力学参数,并建立具有诊断价值的回归模型。

方法

收集 2018 年 12 月至 2021 年 9 月昆明医科大学第二附属医院泌尿外科行 TURP 治疗的 BPH 患者的病历资料,收集患者术前临床资料和尿动力学参数。采用多因素分析确定影响手术疗效的尿动力学参数,并建立具有诊断价值的回归模型并进行评估。

结果

共 201 例患者接受了 TURP 手术,其中 144 例患者术前具有完整的尿动力学数据。对每个尿动力学因素进行多因素分析,发现膀胱收缩力指数(BCI)、膀胱出口梗阻指数(BOOI)、膀胱残余尿量和膀胱顺应性(BC)是影响 BPH 患者 TURP 疗效的独立影响因素。通过接受者操作特征(ROC)分析对回归模型的诊断价值进行分析,发现 AUC=0.939(95%CI 0.886-0.972),其灵敏度和特异度分别为 95.19%和 80%。

结论

该回归模型对预测手术疗效具有较高的诊断灵敏度和特异性,诊断价值高于单个尿动力学因素。因此,BCI、BOOI、膀胱残余尿量和 BC 应被视为影响 TURP 治疗 BPH 手术疗效的独立影响因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d396/10693509/079a08fa33c1/345_2023_4656_Fig1_HTML.jpg

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