Unexpected Long-term Improvements in Urinary and Erectile Function in a Large Cohort of Men with Self-reported Outcomes Following Radical Prostatectomy
Unexpected Long-term Improvements in Urinary and Erectile Function in a Large Cohort of Men with Self-reported Outcomes Following Radical Prostatectomy
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DOI：
10.1016/j.eururo.2015.07.074
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发表时间：
2015-11-01
期刊：
影响因子：
23.4
通讯作者：
Ehdaie, Behfar
中科院分区：
文献类型：
--
作者：
Lee, Justin K.;Assel, Melissa;Ehdaie, Behfar
背景资料：一般认为，如果一个人没有恢复泌尿系统或勃起功能的根治性尿道切除术（RP）12个月内，那么随后的恢复机会是low.Objective：为了确定的概率，达到良好的泌尿功能（UF）或勃起功能（EF）的男性谁在RP后12个月报告差UF或EF术后48个月。设计，设置和参与者：我们确定了2007年至2013年在一家三级机构接受RP的3187例患者，并进行了扩展的多学科随访，患者报告的UF和EF评分>= 12个月。干预：开放或微创RP。结果测量和统计分析：主要结局是良好的UF，定义为尿评分>= 17（范围：0-21）或良好的EF，如通过修改的国际勃起功能指数-6评分>= 22（范围：1-30）定义的。Kaplan-Meier analysis.Results和局限性：在12个月尿失禁的患者中，在24，36和48个月达到良好UF的概率分别为30%，49%和59%。在12个月时出现勃起功能障碍的患者中，在24、36和48个月时恢复EF的概率分别为22%、32%和40%。在多变量分析中，12个月功能评分和年龄与恢复相关，但只有评分始终显着。结论：12个月时失禁或勃起功能障碍的男性后续功能改善率高于预期。恢复概率受12个月时评分的强烈影响。进一步的研究应解决的影响，正在进行的多学科后续护理对我们观察到的率recovery.Patient摘要：许多前列腺癌患者继续恢复泌尿和勃起功能后12个月。12个月时的功能恢复水平与长期恢复相关，在决定康复干预时，医生和患者应进行讨论。(C)2015年欧洲泌尿外科协会。Elsevier B. V.出版，保留所有权利。
Background: It is generally assumed that if a man does not regain urinary continence or erectile function within 12 mo of radical prostatectomy (RP), then the chance of subsequent recovery is low.Objective: To determine the probability of achieving good urinary function (UF) or erectile function (EF) up to 48 mo postoperatively in men who reported poor UF or EF at 12 mo after RP.Design, setting, and participants: We identified 3187 patients who underwent RP from 2007 through 2013 at a tertiary institution and had extended multidisciplinary followup with patient-reported UF and EF scores at >= 12 mo.Intervention: Open or minimally invasive RP.Outcome measurements and statistical analysis: Primary outcome was good UF as defined by a urinary score >= 17 (range: 0-21) or good EF as defined by a modified International Index of Erectile Function-6 score >= 22 (range: 1-30). The probability of functional recovery beyond 12 mo was determined by Kaplan-Meier analyses.Results and limitations: Among patients incontinent at 12 mo, the probability of achieving good UF at 24, 36, and 48 mo was 30%, 49%, and 59%. In patients experiencing erectile dysfunction at 12 mo, the probability of recovering EF at 24, 36, and 48 mo was 22%, 32%, and 40%. On multivariable analyses, 12-mo functional score and age were associated with recovery, but only score was consistently significant.Conclusions: Men with incontinence or erectile dysfunction at 12 mo have higher than anticipated rates of subsequent functional improvement. Probability of recovery is strongly influenced by score at 12 mo. Further research should address the impact of ongoing multidisciplinary follow-up care on our observed rates of recovery.Patient summary: Many prostate cancer patients continue to recover urinary and erectile function after 12 mo. The level of functional recovery by 12 mo is associated with long-term recovery and should be discussed by the physician and patient when deciding on rehabilitative interventions. (C) 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.