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经尿道前列腺电切术后尿道狭窄和尿失禁的危险因素分析

[Analysis of risk factors of urethral stricture and urinary incontinence after transurethral resection of the prostate].

作者信息

Zhang Lu-Feng, Zhan Shao-Yang

机构信息

Department of Urology, Heifei BOE Hospital, Hefei, Anhui 230000, China .

出版信息

Zhonghua Nan Ke Xue. 2023 Jul;29(7):619-624.

Abstract

OBJECTIVE

The purpose of this study was to analyze the risk factors for predicting urethral stricture and urinary incontinence after transurethral resection of the prostate (TURP).

METHODS

A retrospective study of 261 patients admitted from October 2018 to October 2022 who received TURP for benign prostatic hyperplasia (BPH) with complete postoperative follow-up data of at least 6 months. Patients were divided into urethral stricture group (n =18), non-urethral stricture group (n =243), urinary incontinence group (n = 12) and non-urethral incontinence group (n = 249) according to the presence of urethral stricture and urinary incontinence. Compared two groups of patient's age, course of the disease, hypertension, diabetes mellitus, IPSS score, prostate volume, maximum urine flow rate, whether preoperative urinary retention, total prostate specific antigen levels and whether preoperative status, placing a urinary catheter preoperative whether merger urinary tract infection, operative time, postoperative time, postoperative urine tube drawing time placing a urinary catheter, etc. Univariate and multivariate Logistic regression analyses were used to screen for independent predictors.

RESULTS

The incidence of urethral stricture and urinary incontinence after TURP was 6.9% and 4.6%, respectively. Multivariate logistic regression analysis showed that diabetes mellitus (OR = 9.526, 95%CI: 2.824-32.127, P= 0.000); Preoperative urethral infection (OR = 6.500, 95%CI: 1.513-27.925, P = 0.012); Postoperative indwelling catheter time (OR = 2.063, 95%CI: 1.181-3.601, P = 0.011) was an independent risk factor for postoperative urethral stricture. Age (OR = 1.21, 95%CI: 1.027-1.425, P = 0.023); Diabetes mellitus (OR = 37.515, 95%CI: 2.615-538.170, P = 0.008); Postoperative indwelling catheter time (OR = 20.806, 95%CI: 3.090-140.080, P = 0.002) was an independent risk factor for postoperative urinary incontinence.

CONCLUSIONS

Urethral stricture and urinary incontinence are common complications after TURP. Diabetes, preoperative urethral infection, and postoperative catheter indwelling time are independent risk factors for urethral stricture after TURP. Age, diabetes mellitus and postoperative catheter indwelling time were independent risk factors for postoperative urinary incontinence. Diabetes mellitus and postoperative catheter indwelling were common and independent risk factors for urethral stricture and urinary incontinence after TURP.

摘要

目的

本研究旨在分析经尿道前列腺电切术(TURP)后预测尿道狭窄和尿失禁的危险因素。

方法

回顾性研究2018年10月至2022年10月收治的261例行TURP治疗良性前列腺增生(BPH)且术后随访至少6个月的完整数据患者。根据是否存在尿道狭窄和尿失禁将患者分为尿道狭窄组(n = 18)、非尿道狭窄组(n = 243)、尿失禁组(n = 12)和非尿失禁组(n = 249)。比较两组患者的年龄、病程、高血压、糖尿病、国际前列腺症状评分(IPSS)、前列腺体积、最大尿流率、术前是否存在尿潴留、总前列腺特异性抗原水平及术前状态、术前留置导尿管是否合并尿路感染、手术时间、术后时间、术后尿管拔除时间、留置导尿管等情况。采用单因素和多因素Logistic回归分析筛选独立预测因素。

结果

TURP术后尿道狭窄和尿失禁的发生率分别为6.9%和4.6%。多因素Logistic回归分析显示,糖尿病(OR = 9.526,95%CI:2.824-32.127,P = 0.000);术前尿道感染(OR = 6.500,95%CI:1.513-27.925,P = 0.012);术后留置导尿管时间(OR = 2.063,95%CI:1.181-3.601,P = 0.011)是术后尿道狭窄的独立危险因素。年龄(OR = 1.21,95%CI:1.027-1.425,P = 0.023);糖尿病(OR = 37.515,95%CI:2.615-538.170,P = 0.008);术后留置导尿管时间(OR = 20.806,95%CI:3.090-140.080,P = 0.002)是术后尿失禁的独立危险因素。

结论

尿道狭窄和尿失禁是TURP术后常见并发症。糖尿病、术前尿道感染及术后导尿管留置时间是TURP术后尿道狭窄的独立危险因素。年龄、糖尿病及术后导尿管留置时间是术后尿失禁的独立危险因素。糖尿病和术后导尿管留置是TURP术后尿道狭窄和尿失禁常见且独立的危险因素。

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