Urinary continence outcomes of four years of follow-up and predictors of early and late urinary continence in patients undergoing robot-assisted radical prostatectomy
Urinary continence outcomes of four years of follow-up and predictors of early and late urinary continence in patients undergoing robot-assisted radical prostatectomy
复制标题
接受机器人辅助根治性前列腺切除术的患者四年随访的尿失禁结果以及早期和晚期尿失禁的预测因素
DOI：
10.1186/s12894-020-00601-w
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发表时间：
2020-03-18
期刊：
影响因子：
2
通讯作者：
Zhang, Xu
中科院分区：
文献类型：
--
作者：
Li, Xing;Zhang, Huan;Zhang, Xu
背景近年来，机器人辅助根治性膀胱切除术（RARP）得到了广泛的应用，但关于术后长期排尿困难的研究报道较少。本研究的目的是检查的结果，前列腺癌（PCa）接受RARP.MethodsThis回顾性研究包括650例患者接受RARP围手术期数据和至少一年的后续行动，从2009年9月至2017年11月的前列腺癌（PCa）的尿潴留的风险和保护因素。此外，还分析了患者的术前、术中和术后参数。控制性定义为未使用衬垫。早期和晚期复发分别定义为术后3个月内和术后12个月后尿潴留的恢复。术后1 ~ 48个月复查CR。Logistic回归分析评价预测因素与早期和晚期尿潴留之间的关系。结果术后12 ~ 48个月的CR无显著性差异（P= 0.766）。Logistic回归分析显示，盆腔淋巴结清扫术（PLND）是1个月尿潴留的显著危险因素。保留神经（NS）是1、3和6个月时尿潴留的重要保护因素。高龄是6个月、12个月和24个月时尿失禁的独立危险因素。其他变量没有统计学意义的预测指标，泌尿系cardiovascular.ConclusionsThe目前的结果表明，CR逐渐改善1年内的时间和稳定1年后的手术。PLND、NS和年龄分别是早期和晚期复发的重要决定因素。这些参数可用于术前识别高风险患者和咨询术后预期的泌尿系统疾病。
BackgroundThe robot-assisted radical prostatectomy (RARP) has been widely applied in recent years; however, only a few studies are reported about long-term urinary continence after surgery. The present study aimed to examine the outcomes of continence rates (CRs) and determine the risk and protective factors of urinary continence in patients with prostate cancer (PCa) undergoing RARP.MethodsThis retrospective study included 650 patients treated with RARP with perioperative data and at least one year of follow-up from September 2009 to November 2017. Also, the preoperative, intraoperative, and postoperative parameters of the patients were analyzed. Continence was defined as no pad use. Early and late continence was defined as the return of urinary continence within 3 months and beyond 12 months post-surgery, respectively. CRs were examined from 1 to 48 months postoperatively. Logistic regression analysis evaluated the association between the predictive factors and urinary continence in the early and late stages.ResultsNo significant difference was detected in the CR from 12 to 48 months postoperatively (P= 0.766). Logistic regression analysis proved that pelvic lymph node dissection (PLND) was a significant risk factor of urinary continence at 1 month. Nerve-sparing (NS) was a significant protective factor of urinary continence at 1, 3, and 6 months. Advanced age was an independent risk factor of urinary continence at 6, 12, and 24 months. Other variables were not statistically significant predictors of urinary continence.ConclusionsThe current results demonstrated that CR gradually improved with time within 1 year and stabilized 1 year after the surgery. PLND, NS, and age were significant determinants of continence in the early and late stages, respectively. These parameters could be used for preoperative identification of patients at high risk and counseling about postoperative expectations for urinary continence.