Department of Urology, Heji Hospital Affiliated to Changzhi Medical College, Changzhi, Shanaxi, PR. China.
Department of Obstetrics, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanaxi, PR. China.
Int Braz J Urol. 2024 Sep-Oct;50(5):572-584. doi: 10.1590/S1677-5538.IBJU.2024.0011.
With the development of analytical methods, mathematical models based on humoral biomarkers have become more widely used in the medical field. This study aims to investigate the risk factors associated with the occurrence of bladder spasm after transurethral resection of the prostate (TURP) in patients with prostate enlargement, and then construct a nomogram model.
Two hundred and forty-two patients with prostate enlargement who underwent TURP were included. Patients were divided into Spasm group (n=65) and non-spasm group (n=177) according to whether they had bladder spasm after surgery. Serum prostacyclin (PGI2) and 5-hydroxytryptamine (5-HT) levels were measured by enzyme-linked immunoassay. Univariate and multivariate logistic regression were used to analyze the risk factors.
Postoperative serum PGI2 and 5-HT levels were higher in patients in the Spasm group compared with the Non-spasm group (P<0.05). Preoperative anxiety, drainage tube obstruction, and elevated postoperative levels of PGI2 and 5-HT were independent risk factors for bladder spasm after TURP (P<0.05). The C-index of the model was 0.978 (0.959-0.997), with a χ2 = 4.438 (p = 0.816) for Hosmer-Lemeshow goodness-of-fit test. The ROC curve to assess the discrimination of the nomogram model showed an AUC of 0.978 (0.959-0.997).
Preoperative anxiety, drainage tube obstruction, and elevated postoperative serum PGI2 and 5-HT levels are independent risk factors for bladder spasm after TURP. The nomogram model based on the aforementioned independent risk factors had good discrimination and predictive abilities, which may provide a high guidance value for predicting the occurrence of bladder spasm in clinical practice.
随着分析方法的发展，基于体液生物标志物的数学模型在医学领域得到了更广泛的应用。本研究旨在探讨前列腺增生患者经尿道前列腺电切术（TURP）后发生膀胱痉挛的相关危险因素，并构建列线图模型。
纳入 242 例前列腺增生患者，根据术后是否发生膀胱痉挛分为痉挛组（n=65）和非痉挛组（n=177）。采用酶联免疫吸附法检测血清前列环素（PGI2）和 5-羟色胺（5-HT）水平。采用单因素和多因素 logistic 回归分析危险因素。
痉挛组患者术后血清 PGI2 和 5-HT 水平高于非痉挛组（P<0.05）。术前焦虑、引流管堵塞和术后 PGI2、5-HT 水平升高是 TURP 后发生膀胱痉挛的独立危险因素（P<0.05）。模型的 C 指数为 0.978（0.959-0.997），Hosmer-Lemeshow 拟合优度检验 χ2=4.438（p=0.816）。评估列线图模型区分能力的 ROC 曲线显示 AUC 为 0.978（0.959-0.997）。
术前焦虑、引流管堵塞和术后血清 PGI2、5-HT 水平升高是 TURP 后发生膀胱痉挛的独立危险因素。基于上述独立危险因素的列线图模型具有良好的区分度和预测能力，可能为临床实践中预测膀胱痉挛的发生提供较高的指导价值。
