Barakat Bara, Hadaschik Boris, Al-Nader Mulham, Schakaki Samer
Urology Centre, Albertusstraße 17, 41061 Moenchengladbach, Germany.
Department of Urology and Pediatric Urology, Hospital Viersen, 41747 Viersen, Germany.
J Clin Med. 2024 Nov 11;13(22):6780. doi: 10.3390/jcm13226780.
Stress urinary incontinence (SUI) is a common condition in patients following radical prostatectomy (RP), which has a significant impact on all aspects of quality of life and is associated with significant social stigma. The factors that improve urinary incontinence in patients following surgery remain controversial. The aim of our narrative review was to identify and synthesise the latest evidence on pre-, intra- and post-operative factors and predictors that contribute to early continence recovery after RP. In this narrative review, primary resources were identified by searching PubMed, EMBASE and Medline, and secondary resources were collected by cross-referencing citations in the relevant articles. We started our review by searching for systematic reviews of factors and predictors that contribute to early recovery of urinary continence after RP. We then reviewed societal guidelines such as the American Urological Association and European Urological Association guidelines on male urinary incontinence. This review focuses on the pre-, intra and postoperative factors that influence postoperative SUI after RP, as well as highlighting modifications in surgical techniques that lead to early continence recovery. Increasing age, higher BMI, shorter membranous urethral length (MUL), and larger PV are independent prognostic factors for SUI within 3 months after RP. Factors such as modified surgical technique preservation of anatomical structure lead to influence postoperative early continence recovery. SUI after RP is influenced by various factors. These factors include not only anatomical landmarks and patient-related factors such as age, BMI, length of MUL and prostate volume, but also prior transurethral resection or laser enucleation of the prostate, the surgeon's expertise, the surgical approach and NS technique.
压力性尿失禁（SUI）是根治性前列腺切除术（RP）后患者的常见病症，对生活质量的各个方面都有重大影响，且与严重的社会耻辱感相关。改善术后患者尿失禁的因素仍存在争议。我们的叙述性综述旨在识别并综合关于术前、术中和术后因素以及预测指标的最新证据，这些因素有助于RP术后早期恢复控尿功能。在本叙述性综述中，通过检索PubMed、EMBASE和Medline确定了主要资源，并通过交叉引用相关文章中的参考文献收集了次要资源。我们通过搜索关于RP术后有助于早期恢复尿控的因素和预测指标的系统综述来开始我们的综述。然后我们回顾了社会指南，如美国泌尿外科学会和欧洲泌尿外科学会关于男性尿失禁的指南。本综述重点关注影响RP术后SUI的术前、术中和术后因素，并强调导致早期恢复控尿功能的手术技术改进。年龄增加、BMI较高、膜性尿道长度（MUL）较短以及前列腺体积（PV）较大是RP术后3个月内SUI的独立预后因素。诸如改良手术技术、保留解剖结构等因素会影响术后早期控尿功能的恢复。RP术后的SUI受多种因素影响。这些因素不仅包括解剖标志以及年龄、BMI、MUL长度和前列腺体积等患者相关因素，还包括既往经尿道前列腺切除术或前列腺激光剜除术、外科医生的专业技能、手术入路和神经保留技术。
