Cine magnetic resonance imaging provides novel predictors of early continence recovery after radical prostatectomy: Assessment of the dynamics of pelvic floor muscles
Cine magnetic resonance imaging provides novel predictors of early continence recovery after radical prostatectomy: Assessment of the dynamics of pelvic floor muscles
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DOI：
10.1002/nau.24544
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发表时间：
2020-10-16
影响因子：
2
通讯作者：
Takeda, Masayuki
中科院分区：
文献类型：
--
作者：
Shimura, Hiroshi;Kuwahara, Yoshitaka;Takeda, Masayuki
目的尿道切除术后尿失禁是尿道切除术的主要并发症。虽然骨盆底肌肉训练可以成功治疗尿道切除术后尿失禁，但缺乏肌肉运动如何影响尿道恢复的证据。我们使用电影磁共振成像评估直肠切除术患者的动态因素，以确定直肠切除术后尿失禁的危险因素，并揭示骨盆底肌肉对直肠恢复的贡献。方法128例前列腺癌患者行机器人辅助腹腔镜手术。术前和术后6个月进行电影磁共振成像。控制被定义为无垫或使用安全垫。我们将骨盆底肌肉训练期间的膀胱颈抬高距离定义为膀胱抬高距离。术后1个月内尿失禁恢复的患者为尿失禁组（n = 48）;其他患者为尿失禁组（n = 80）。结果术前膀胱上举距离在尿失禁组中明显长于尿失禁组（10.4 vs. 8.2 mm;p <0.001）。膀胱镜组的术后膀胱抬高距离往往更长（9.9与8.9 mm;p = 0.057）。多变量分析显示，术前膀胱抬高距离显著有助于膀胱功能恢复（p = 0.016）。术前膀胱抬高距离较长（>8.5 mm）的患者术后恢复明显快于术前膀胱抬高距离较短（
Aims Postprostatectomy incontinence is a major complication of prostatectomy. Although pelvic floor muscle training can successfully treat postprostatectomy incontinence, evidence for how muscle movement affects continence recovery is lacking. We evaluated dynamic factors of prostatectomy patients using cine magnetic resonance imaging to identify risk factors for postprostatectomy incontinence and reveal the contribution of pelvic floor muscles to continence recovery. Methods A total of 128 prostate cancer patients who underwent robot-assisted laparoscopic surgery were enrolled. Cine magnetic resonance imaging was performed preoperatively and 6 months after surgery. Continence was defined as pad-free or use of safety pads. We defined the bladder neck elevation distance during pelvic floor muscle training as the bladder elevation distance. Patients with continence recovery within 1 month comprised the continence group (n = 48); other patients comprised the incontinence group (n = 80). Results The preoperative bladder elevation distance was significantly longer in the continence group than in the incontinence group (10.4 vs. 8.2 mm;p < .001). The postoperative bladder elevation distance of the continence group tended to be longer (9.9 vs. 8.9 mm;p = .057). Multivariate analysis showed that the preoperative bladder elevation distance significantly contributed to continence recovery (p = .016). Patients with a longer preoperative bladder elevation distance (>8.5 mm) experienced continence recovery significantly faster than patients with a shorter distance (