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探索逆行性肾内手术中针对性别方法的影响:对手术效率和患者恢复的作用

Exploring the Impact of Gender-Specific Approaches inRetrograde Intrarenal Surgery: Effects on Operative Efficiency and Patient Recovery.

作者信息

Hilowle Abdihamid Hassan, Mohamed Abdikarim Hussein

机构信息

Department of Urology, Mogadishu Urological Center, Mogadishu, Somalia.

Department of Urology, University of Somalia, Mogadishu, Somalia.

出版信息

Res Rep Urol. 2024 Aug 30;16:177-185. doi: 10.2147/RRU.S480374. eCollection 2024.

Abstract

OBJECTIVE

Very limited data are available exploring the potential influence of gender on Retrograde Intrarenal Surgery outcomes. This study investigates the gender-specific influence of ShuoTongureteroscopy (ST-urs) and Flexible Ureteroscopy (F-urs) surgeries on operation efficacy and patient recovery in a sample of the Somali population.

MATERIALS AND METHODS

We enrolled 390 participants. Participants were stratified into four gender-specific subgroups based on ureteroscopy operation type: 27.7% males in S-urs (group1), 44.4% females in S-urs (group2), 18.7% males in F-urs (group3), and 9.2% females in F-urs (group4). Primary outcomes included operation time, postoperative hospital stay duration, and VAS Pain Score. Multivariate logistic regression was used to assess associations.

RESULTS

The mean age was 29.53 ± 7.61 years, 72.1% male and 27.9% female, with 46.4% of the patients undergoing ST-urs and 53.6% undergoing F-urs. Women had higher odds of prolonged hospital stays (OR = 2.62, 95% CI: 1.43-4.82, p < 0.001) and post-operation pain (OR = 5.06, 95% CI: 2.95-8.68, p = 0.002). Among men who underwent F-urs procedure, there was a significantly higher odds ratio (OR) of 6.14 (95% CI: 2.86-13.19, p < 0.001) for experiencing a long operation time. Conversely, for females, those who underwent S-urs surgery had a notably lower OR of 0.32 (95% CI: 0.13-0.79, p = 0.013) for long operation time, whereas those who underwent F-urs surgery exhibited a substantially elevated OR of 5.36 (95% CI: 1.85-15.53, p < 0.001). Both females undergoing F-urs surgery (OR: 5.16, 95% CI: 2.61-10.21, p < 0.001) and those undergoing F-urs surgery (OR: 5.25, 95% CI: 2.17-12.73, p < 0.001) experienced significantly higher post-operative pain.

CONCLUSION

Our research reveals gender disparities in retrograde intrarenal surgery outcomes. Women experience longer hospital stays and higher postoperative pain levels compared to men. F-urs procedures are associated with longer operation times and hospital stays, particularly affecting women. Contrarily, ST-urs offers shorter operation times for women but leads to prolonged hospital stays and heightened postoperative pain.

摘要

目的

关于性别对逆行性肾内手术结果潜在影响的研究数据非常有限。本研究调查了硕通输尿管镜(ST-urs)和软性输尿管镜(F-urs)手术对索马里人群样本中手术疗效和患者恢复的性别特异性影响。

材料与方法

我们招募了390名参与者。根据输尿管镜手术类型,参与者被分为四个性别特异性亚组:ST-urs组中男性占27.7%(第1组),ST-urs组中女性占44.4%(第2组),F-urs组中男性占18.7%(第3组),F-urs组中女性占9.2%(第4组)。主要结局包括手术时间、术后住院时间和视觉模拟评分法疼痛评分。采用多因素逻辑回归分析相关性。

结果

平均年龄为29.53±7.61岁,男性占72.1%,女性占27.9%,46.4%的患者接受ST-urs手术,53.6%的患者接受F-urs手术。女性术后住院时间延长(比值比[OR]=2.62,95%置信区间[CI]:1.43 - 4.82,p<0.001)和术后疼痛的几率更高(OR = 5.06,95% CI:2.95 - 8.68,p = 0.002)。在接受F-urs手术的男性中,手术时间长的几率显著更高(OR为6.14,95% CI:2.86 - 13.19,p<0.001)。相反,对于女性,接受ST-urs手术的患者手术时间长的OR显著较低,为0.32(95% CI:0.13 - 0.79,p = 0.013),而接受F-urs手术的患者OR大幅升高,为5.36(95% CI:1.85 - 15.53,p<0.001)。接受F-urs手术的女性(OR:5.16,95% CI:2.61 - 10.21,p<0.001)和接受F-urs手术的女性(OR:5.25,95% CI:2.17 - 12.73,p<0.001)术后疼痛均显著更严重。

结论

我们的研究揭示了逆行性肾内手术结果中的性别差异。与男性相比,女性术后住院时间更长,术后疼痛程度更高。F-urs手术与更长的手术时间和住院时间相关,对女性影响尤为明显。相反,ST-urs手术对女性手术时间较短,但会导致住院时间延长和术后疼痛加剧。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd72/11370754/6ec7ed67c28f/RRU-16-177-g0001.jpg

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