Racial Variation in Membranous Urethral Length and Postprostatectomy Urinary Function.
Racial Variation in Membranous Urethral Length and Postprostatectomy Urinary Function.
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DOI：
10.1016/j.euros.2021.03.001
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发表时间：
2021-05
影响因子：
2.5
通讯作者：
Hu JC
中科院分区：
文献类型：
--
作者：
Basourakos SP;Ramaswamy A;Yu M;Margolis DJ;Hu JC
尿失禁仍然是前列腺切除术后的一个重要后遗症。虽然已发现许多患者和技术因素导致前列腺术后尿失禁，但种族解剖差异的影响尚未被研究。术前前列腺磁共振成像显示较短的膜性尿路长度(MUL)与前列腺术后尿失禁的风险较高有关。我们使用临床用扩展前列腺癌综合指数(EPIC-CP)比较了亚洲和非亚洲男性的MUL和他们前列腺癌切除术后的排尿功能。我们发现，亚裔男性的MUL(7.9 mm，95%可信区间[CI]7.5-8.3)明显短于非亚裔男性(10.9 mm，95%CI 10.2-11.7)，平均差异为3.0 mm(95%CI为2.15-3.87；p<0.01)。此外，亚裔男性术后12个月的EPIC-CP尿≥评分(3.82分，95%可信区间2.47~5.17分)明显低于非亚裔男性(1.95分，95%可信区间为1.11~2.79分)，平均差值为1.87分(95%可信区间为0.32~3.42；P=0.022)。需要进行验证性研究来探讨MUL的种族差异及其对前列腺术后尿失禁的影响。我们比较了亚裔和非亚裔男性的特定部分(称为膜性尿路)的长度和摘除前列腺后的排尿功能。我们发现，亚洲男性的膜性尿路明显较短，摘除前列腺后，他们的尿控更差。需要更多的研究来证实我们的发现。
Urinary incontinence remains a significant postprostatectomy sequala. While it has been found that many patient and technical factors contribute to postprostatectomy incontinence, the impact of anatomical differences by races has not been studied. Shorter preoperative membranous urethral length (MUL) on prostate magnetic resonance imaging has been associated with a higher risk of postprostatectomy incontinence. We compared MUL between Asian and non-Asian men and their postprostatectomy urinary function using the Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP). We found that MUL was significantly shorter for Asian (7.9 mm, 95% confidence interval [CI] 7.5–8.3) than for non-Asian men (10.9 mm, 95% CI 10.2–11.7), with a mean difference of 3.0 mm (95% CI 2.15–3.87; p < 0.01). In addition, Asian men had significantly worse EPIC-CP urinary scores ≥12 mo after prostatectomy (3.82, 95% CI 2.47–5.17) in comparison to non-Asian men (1.95, 95% CI 1.11–2.79), with a mean difference of 1.87 (95% CI 0.32–3.42; p = 0.022). Confirmatory studies are needed to explore racial differences in MUL and its effect on postprostatectomy incontinence. We compared the length of a specific section of the urethra (called the membranous urethra) and urinary function after removal of the prostate between Asian and non-Asian men. We found that the membranous urethra is significantly shorter in Asian men and they have worse urinary continence after removal of the prostate. More studies are needed to confirm our findings.