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钬激光前列腺剜除术(HoLEP)后短暂性尿失禁的预测因素:单中心经验。

Predictive Factors of Transient Urinary Incontinence Following Holmium Laser Enucleation of the Prostate (HoLEP): Single-Center Experience.

机构信息

Department of Urology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.

Department of Urology, Medicover Hospital, 407062 Suceagu, Romania.

出版信息

Medicina (Kaunas). 2024 Sep 6;60(9):1460. doi: 10.3390/medicina60091460.

Abstract

: The aim of this study was to assess the predictive factors associated with transient urine incontinence (TUI) following holmium laser enucleation of the prostate (HoLEP). : A retrospective analysis was conducted on a prospectively maintained database containing the first 149 consecutive HoLEP cases between June 2022 and December 2023. The study recorded several patient characteristics, and preoperative data such as IPSS score, total gland volume, preoperative catheterization, Qmax, and PVR volume were collected. During the operation, data on total operating time, enucleation time, morcellation time, and weight of enucleated tissue were recorded. Finally, postoperative data were also documented. TUI refers to a patient's complaint of urine leakage, irrespective of type. Univariate and multivariate logistic regression analyses were performed to determine factors that predict TUI. : The study included 119 patients with BPH. Nineteen (15.96%) of them experienced postoperative TUI. Of those 19 patients, 15 (78.94%) recovered within three months from the date of the surgery. In the multivariate regression analysis, increased age (odds ratio [OR], 3.47; 95% confidence interval [CI], 1.56~7.78; = 0.002), prostate volume ≥ 100 mL (OR 1.86; 95% CI 1.54-2.13; = 0.001), preoperative PVR volume ≥ 250 mL (OR 1.22; 95% CI 1.10-1.32; = 0.02), preoperative catheterization (OR, 0.56; 95% CI 0.34-0.78; = 0.003), increased operation time (OR, 3.87; 95% CI 1.62-4.19; = 0.002), and resected tissue weight ≥ 40 g (OR, 1.032; 95% CI, 1.015-1.048; = 0.002) were found to be independent predictors of TUI. : The incidence of TUI following HoLEP was found to be 15.96% in patients, with a recovery rate of 78.94% within three months post-surgery. Predictive factors for TUI included age at surgery, prostatic volume, preoperative catheterization, high PVR, longer operative time, and resected tissue weight.

摘要

: 本研究旨在评估与钬激光前列腺剜除术(HoLEP)后短暂性尿失禁(TUI)相关的预测因素。 : 对 2022 年 6 月至 2023 年 12 月期间连续进行的 149 例 HoLEP 病例的前瞻性数据库进行了回顾性分析。该研究记录了患者的多项特征以及术前数据,如 IPSS 评分、前列腺总体积、术前导尿、Qmax 和 PVR 体积。术中记录总手术时间、剜除时间、切碎时间和剜除组织重量。最后,还记录了术后数据。TUI 是指患者对尿失禁的抱怨,不论类型。采用单变量和多变量逻辑回归分析来确定预测 TUI 的因素。 : 研究纳入了 119 例 BPH 患者。其中 19 例(15.96%)术后出现 TUI。在这 19 例患者中,15 例(78.94%)在术后三个月内恢复。多变量回归分析中,年龄增加(比值比 [OR],3.47;95%置信区间 [CI],1.56~7.78; = 0.002)、前列腺体积≥100 mL(OR 1.86;95% CI 1.54-2.13; = 0.001)、术前 PVR 体积≥250 mL(OR 1.22;95% CI 1.10-1.32; = 0.02)、术前导尿(OR,0.56;95% CI 0.34-0.78; = 0.003)、手术时间增加(OR,3.87;95% CI 1.62-4.19; = 0.002)和切除组织重量≥40 g(OR,1.032;95% CI,1.015-1.048; = 0.002)被发现是 TUI 的独立预测因素。 : HoLEP 术后 TUI 的发生率为 15.96%,术后 3 个月内的恢复率为 78.94%。TUI 的预测因素包括手术时的年龄、前列腺体积、术前导尿、高 PVR、较长的手术时间和切除组织的重量。

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