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经尿道钬激光前列腺剜除术后尿失禁的分析及影响因素。

Analysis of Postoperative Urinary Incontinence and Influencing Factors of Transurethral Holmium Laser Enucleation of the Prostate.

机构信息

Department of Urology, The Third Affiliated Hospital of Guangxi Medical University, Nanning, China,

Department of Urology, The Third Affiliated Hospital of Guangxi Medical University, Nanning, China.

出版信息

Urol Int. 2024;108(5):457-463. doi: 10.1159/000539201. Epub 2024 May 14.

Abstract

INTRODUCTION

Aims of the study were to investigate the related factors of urinary incontinence after transurethral holmium laser enucleation of the prostate (HoLEP) and to provide guidance for clinical urinary control of HoLEP.

METHODS

The clinical data of 548 patients who underwent HoLEP were retrospectively analyzed. The patients were followed up for the occurrence of urinary incontinence in the short term (2 weeks), medium term (3 months), and long term (6 months) after HoLEP.

RESULTS

Among the 548 benign prostatic hyperplasia patients, 79 cases (14.42%) had urinary incontinence at 2 weeks, 19 cases (3.47%) at 3 months, and 2 cases (0.36%) at 6 months after surgery. Logistic regression analysis showed that age, prostate volume, diabetes mellitus, operation time, prostate tissue weight, and histological prostatitis were risk factors for recent urinary incontinence (p < 0.05). Age, diabetes, and operation time were risk factors for mid-term urinary incontinence (p < 0.05). The incidence of long-term urinary incontinence was low and no risk factor analysis was performed.

CONCLUSIONS

For good urinary control after HoLEP, in addition to surgery-related factors such as surgical skills, proficiency, and precise anatomy, patients' risk factors should also be paid attention to in order to improve postoperative urinary control more effectively and reduce the incidence of urinary incontinence.

摘要

简介

本研究旨在探讨经尿道钬激光前列腺剜除术(HoLEP)后尿失禁的相关因素,为 HoLEP 的临床尿控提供指导。

方法

回顾性分析 548 例行 HoLEP 的患者的临床资料。对患者进行短期(2 周)、中期(3 个月)和长期(6 个月)随访,观察 HoLEP 后尿失禁的发生情况。

结果

548 例良性前列腺增生患者中,术后 2 周有 79 例(14.42%)发生尿失禁,3 个月时有 19 例(3.47%),6 个月时有 2 例(0.36%)。Logistic 回归分析显示,年龄、前列腺体积、糖尿病、手术时间、前列腺组织重量和组织学前列腺炎是近期尿失禁的危险因素(p < 0.05)。年龄、糖尿病和手术时间是中期尿失禁的危险因素(p < 0.05)。长期尿失禁发生率较低,未行危险因素分析。

结论

为了更好地控制 HoLEP 术后尿失禁,除了手术相关因素(如手术技巧、熟练度和精确解剖)外,还应注意患者的危险因素,以便更有效地改善术后尿控,降低尿失禁的发生率。

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