Impact of variations in prostatic apex shape on early recovery of urinary continence after radical retropubic prostatectomy
Impact of variations in prostatic apex shape on early recovery of urinary continence after radical retropubic prostatectomy
复制标题
DOI：
10.1016/j.urology.2006.01.021
复制
发表时间：
2006-07-01
期刊：
影响因子：
2.1
通讯作者：
Hong, Sung Kyu
中科院分区：
文献类型：
--
作者：
Lee, Sang Eun;Byun, Seok-Soo;Hong, Sung Kyu
目标.研究术前磁共振成像（MRI）上观察到的前列腺尖端形状变化对患者接受根治性耻骨后前列腺切除术后尿失禁状况的影响，以及此类变化的患病率。我们对156例术前接受前列腺MRI检查的患者进行了回顾性分析，并通过回顾记录进行了术后随访。在我们的分析中，根据正中矢状位MRI扫描显示的前列腺尖部形状，将患者分为四组。患者的状态，包括早期（手术后3个月内）恢复排尿困难，也进行了评估。第1组最多，有59例患者（37.8%），第2组有39例患者（25%），第3组有24例患者（15.3%），第4组有34例患者（21.8%）。第4组包括在MR 1上前列腺尖与膜尿道不重叠的患者，与其他组相比，根治性耻骨后尿道切除术后早期尿潴留患者的百分比显著更高（83.3%对66.7%）（P = 0.014）。在多变量分析预测因素的早期恢复尿失禁，前或后重叠的膜尿道前列腺尖显示术前MRI是唯一的变量显着与早期恢复的continence。结论。我们的研究结果提供了客观的证据，前列腺尖部的形状相对于尿道膜部的变化可能会显着影响根治性耻骨后尿道切除术后的早期恢复。
Objectives. To investigate the impact of the variations in the shape of the prostatic apex observed on preoperative magnetic resonance imaging (MRI) on patients' status regarding urinary continence after undergoing radical retropubic prostatectomy, as well as the prevalence of such variations.Methods. We performed a retrospective analysis of 156 patients who had undergone preoperative MRI of the prostate and were followed up postoperatively by review of the records. For our analyses, patients were categorized into four different groups according to the shape of the prostatic apex shown on the midsagittal MRI scan. Patient status, including early (within 3 months after surgery) recovery of urinary continence, was also assessed.Results. Group 1 was the largest with 59 patients (37.8%), group 2 had 39 patients (25%), group 3 had 24 (15.3%), and group 4 had 34 patients (21.8%). Group 4 was composed of patients with the prostatic apex not overlapping with membranous urethra either anteriorly or posteriorly on MR1 and had a significantly greater percentage (83.3% versus 66.7%) of patients with an early return of urinary continence after radical retropubic prostatectomy compared with the other groups (P = 0.014). On multivariate analysis of the predictive factor for the early return of urinary continence, anterior or posterior overlapping of the membranous urethra with the prostatic apex as shown on preoperative MRI was the only variable significantly associated with an early return of continence.Conclusions. The results of our study provide objective evidence that variations in the shape of the prostatic apex in relation to the membranous urethra may significantly affect early recovery of urinary continence after radical retropubic prostatectomy.