Imai Hitomi, Akaihata Hidenori, Harigane Yuki, Yaginuma Kei, Meguro Satoru, Honda-Takinami Ruriko, Matsuoka Kanako, Hoshi Seiji, Hata Junya, Sato Yuichi, Ogawa Soichiro, Uemura Motohide, Kojima Yoshiyuki
Department of Urology, Fukushima Medical University School of Medicine.
Fukushima J Med Sci. 2025 Jul 3;71(3):169-175. doi: 10.5387/fms.24-00057. Epub 2025 Apr 11.
This study investigated whether preoperative patient characteristics and surgery-related factors affect postoperative de novo overactive bladder (OAB) after robot-assisted radical prostatectomy (RARP), and identified three predictive markers.
Patients without preoperative OAB who underwent RARP at our hospital between February 2013 and October 2020 were included. At 12 months post-RARP, patients were divided into OAB-free and de novo OAB groups based on the presence of overactive bladder. Preoperative patient characteristics and surgery-related factors were compared between the two groups.
A total of 404 patients were analyzed (OAB-free group, 338; de novo OAB group, 66). The preoperative Overactive Bladder Symptom Score (OABSS) and the percentage of patients with dyslipidemia were significantly higher in the de novo OAB group than in the OAB-free group (OABSS, 3.2 ± 1.6 points vs 2.1 ± 1.4, P<0.01; dyslipidemia, 45.5% vs 32.0%, P=0.04). Nerve-sparing surgery was significantly less common in the de novo OAB group (10.6% vs 27.1%, P<0.01). Preoperative age, blood pressure, BMI, HbA1c, uroflowmetry parameters, prostate volume, operative time and blood loss showed no significant differences between two groups.
High preoperative OABSS, preoperative dyslipidemia and non-nerve-sparing surgery may be predictive markers for de novo OAB after RARP.
本研究调查了术前患者特征和手术相关因素是否会影响机器人辅助根治性前列腺切除术（RARP）术后新发膀胱过度活动症（OAB），并确定了三个预测指标。
纳入2013年2月至2020年10月在我院接受RARP且术前无OAB的患者。RARP术后12个月，根据膀胱过度活动症的存在情况将患者分为无OAB组和新发OAB组。比较两组术前患者特征和手术相关因素。
共分析404例患者（无OAB组338例；新发OAB组66例）。新发OAB组术前膀胱过度活动症症状评分（OABSS）和血脂异常患者百分比显著高于无OAB组（OABSS，3.2±1.6分对2.1±1.4分，P<0.01；血脂异常，45.5%对32.0%，P=0.04）。新发OAB组保留神经手术显著较少见（10.6%对27.1%，P<0.01）。两组术前年龄、血压、BMI、糖化血红蛋白、尿流率参数、前列腺体积、手术时间和失血量无显著差异。
术前高OABSS、术前血脂异常和非保留神经手术可能是RARP术后新发OAB的预测指标。
