Department of Urology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
Biostatistics and Data Management, Sapporo Medical University, Sapporo, Hokkaido, Japan.
Int J Urol. 2024 May;31(5):492-499. doi: 10.1111/iju.15388. Epub 2024 Jan 9.
We investigated the correlation between surgical outcomes and postoperative urinary continence recovery in robot-assisted radical prostatectomy (RARP).
Patients who underwent RARP in our institution (n = 195) were included in this study. Preserved urethral length (PUL) was assessed during the procedure. Other outcomes of the surgical procedure were collected from operative records. Kaplan-Meier analysis with log-rank test was used to compare urinary continence recovery rate with the PUL, sparing of the neurovascular bundle (NVB), and other surgical procedures. Univariate and multivariate analyses were performed using Cox proportional hazards model, and p-values of <0.05 were considered significant.
Patients with a PUL ≥26 mm had 10.0%, 24.7%, 36.6%, and 89.0% continence recovery rates at 30, 60, 90, and 365 days after surgery, respectively, while patients with a PUL <26 mm had 0%, 17.8%, 26.1%, and 80.9% recovery rates, respectively. Kaplan-Meier curves showed significantly better postoperative urinary continence recovery at 30 days after RARP in patients with a PUL ≥26 mm than those with a PUL <26 mm (p = 0.0028) and in patients with NVB preservation than those with no NVB preservation (p = 0.014). Urinary continence recovery within 30, 60, and 90 days after surgery was 90.6% for patients with a PUL of ≥26 mm and NVB preservation, while only 82.3% for patients with a PUL of <26 mm or no NVB preservation.
Our results suggest that a PUL ≥26 mm and NVB preservation after RARP correlate with a significantly higher postoperative rate of recovery of urinary continence.
我们研究了机器人辅助前列腺根治性切除术（RARP）中手术结果与术后尿控恢复之间的相关性。
本研究纳入了在我院接受 RARP 的患者（n=195）。术中评估了保留尿道长度（PUL）。手术记录中收集了其他手术结果。使用 Kaplan-Meier 分析和对数秩检验比较了 PUL、保留神经血管束（NVB）和其他手术操作与尿控恢复率的关系。使用 Cox 比例风险模型进行单因素和多因素分析，p 值<0.05 为差异有统计学意义。
PUL≥26mm 的患者术后 30、60、90 和 365 天的尿控恢复率分别为 10.0%、24.7%、36.6%和 89.0%，而 PUL<26mm 的患者分别为 0%、17.8%、26.1%和 80.9%。Kaplan-Meier 曲线显示，PUL≥26mm 的患者术后 30 天的尿控恢复明显优于 PUL<26mm 的患者（p=0.0028），也明显优于未保留 NVB 的患者（p=0.014）。术后 30、60 和 90 天的尿控恢复率，PUL≥26mm 且保留 NVB 的患者为 90.6%，而 PUL<26mm 或未保留 NVB 的患者仅为 82.3%。
我们的研究结果表明，RARP 后 PUL≥26mm 和保留 NVB 与术后尿控恢复率显著提高相关。
