Continence following radical retropubic prostatectomy using self-reporting instruments
Continence following radical retropubic prostatectomy using self-reporting instruments
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DOI：
10.1097/01.ju.0000110631.81774.9c
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发表时间：
2004-03-01
影响因子：
6.6
通讯作者：
Xue, XN
中科院分区：
文献类型：
--
作者：
Lepor, H;Kaci, L;Xue, XN
目的：我们在根治性耻骨后前列腺切除术 (RRP) 后进行了全面的节制自我评估，并确定了这种全面的节制自我评估与常用的节制定义之间的关系。 材料和方法：2000 年 10 月至 2002 年 2 月期间，鼓励所有接受 RRP 的男性在术后 3、6、12 和 24 个月完成加州大学洛杉矶分校前列腺癌指数。从 2002 年 10 月开始，术后失禁评估中添加了一个反映患者失禁状态整体自我评估的单一问题。该研究设计是横断面的，因为仅对 2002 年 10 月至 2003 年 2 月期间提交的失禁调查进行了评估。根据患者对失禁的总体评估与基于尿垫要求、失禁引起的问题和失禁频率的失禁定义之间的关系，确定了敏感性、特异性和 K 系数。结果：在 RRP 后 3 至 24 个月，所有失禁结果的失禁情况逐渐改善。 RRP 后 24 个月时，97.1% 的男性认为自己可以节制，而使用节制定义（包括要求在 24 小时间隔内不使用卫生巾或 1 个卫生巾、不因失禁而完全控制或偶尔流口水而没有或轻微困扰）分别有 97.1%、94.1% 和 97.1% 的人认为自己可以节制。我们对加州大学洛杉矶分校前列腺癌指数的 3 种节制定义与患者对节制的整体自我评估非常一致（K 系数在 0.76 和 0.83 之间）。结论：大多数男性在 RRP 后无需侵入性干预即可实现节制。最终的节制状态应在 24 个月时确定。患者对失禁的整体评估根据对经过验证的自填问卷的答复，为其他失禁定义提供了表面有效性。
Purpose: We performed a global self-assessment of continence following radical retropubic prostatectonly (RRP) and determined how this global self-assessment of continence correlates with commonly used definitions of continence.Materials and Methods: Between October 2000 and February 2002 all men who underwent RRP were encouraged to complete the University of California-Los Angeles Prostate Cancer Index 3, 6, 12 and 24 months postoperatively. Beginning October 2002 a single question capturing the patient global self-assessment of continence status was added to the postoperative continence assessment. The study design was cross-sectional since only continence surveys submitted between October 2002 through February 2003 were evaluated. Sensitivity, specificity and K coefficient was determined for the relationship between the patient global assessment of continence vs the definition of continence based on pad requirement, problem due to incontinence and frequency of incontinence.Results: Continence progressively improved 3 to 24 months following RRP for all continence outcomes. At 24 months following RRP 97.1% of men considered themselves continent, while 97.1%, 94.1% and 97.1% were considered continent using continence definitions, including the requirement of no or 1 pad in a 24-hour interval, no or slight bother due to incontinence and total control or occasional dribbling, respectively. Our 3 definitions of continence derived from responses to the University of California-Los Angeles Prostate Cancer Index had excellent agreement with patient global self-assessment of continence (K coefficients between 0.76 and 0.83).Conclusions: The majority of men achieve continence without invasive intervention following RRP. Final continence status should be ascertained at 24 months. The patient global assessment of continence provides face validity for other definitions of continence based on responses to validated self-administered questionnaires.