Predictors for immediate recovery of continence following Retzius-sparing robot-assisted radical prostatectomy: a case-control study
Predictors for immediate recovery of continence following Retzius-sparing robot-assisted radical prostatectomy: a case-control study
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保留 Retzius 的机器人辅助根治性前列腺切除术后失禁立即恢复的预测因素：病例对照研究。
DOI：
10.1007/s11255-018-02071-4
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发表时间：
2019-05-01
影响因子：
2
通讯作者：
Guo, Hongqian
中科院分区：
文献类型：
--
作者：
Qin, Haixiang;Qiu, Xuefeng;Guo, Hongqian
目的 我们评估了一系列接受保留 Retzius 机器人辅助根治性前列腺切除术 (RS-RARP) 的连续患者的尿失禁情况，以确定恢复即刻尿失禁的术前预测因素。方法 回顾性收集 110 名因临床局限性前列腺癌而接受 RS-RARP 的连续患者。拔除导尿管后7天内不再使用安全垫（0垫/天）的患者被定义为立即尿失禁。结果共有85例患者（77.27%）在RS-RARP后立即尿失禁。立即尿失禁患者比尿失禁患者明显年轻（66.92 +/- 5.73 vs. 69.68 +/- 4.99 岁，p=0.031）。此外，与立即尿失禁患者相比，前列腺体积显着较小（30.90 vs. 44.60 ml，p=0.001），术前国际前列腺症状评分（IPSS）显着较低（轻度 76.5% vs. 24.0%，中度 20.0% vs. 32.0%，重度 3.5% vs. 44.0%，p=0.000）。那些不是的人。在单变量回归分析中，患者年龄（OR 0.907，p=0.035）、前列腺体积（OR 0.935，p=0.000）、中度（OR 0.196，p=0.007）和重度IPSS（OR 0.025，p=0.000）（与轻度IPSS相比）是即刻尿失禁的独立不良预测因素。多变量分析显示，前列腺体积（OR 0.955，p=0.032）和严重术前IPSS（OR 0.044，p=0.000）（与轻度IPSS相比）是RS-RARP术后即刻尿失禁的独立不良预测因素。 结论 RS-RARP可加速术后尿失禁的恢复。前列腺体积和严重的术前 IPSS 是恢复即刻尿失禁的独立不良预测因素。
Purpose We evaluated urinary continence in a series of consecutive patients who underwent Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) to identify the preoperative predictors of the return to immediate urinary continence.Methods 110 consecutive patients who underwent RS-RARP for clinically localized prostate cancer were retrospectively collected. Patients reported freedom from using safety pad (0pad/day) within 7days after removal of urinary catheter were defined as immediate urinary continent.Results A total of 85 patients (77.27%) were immediate urinary continent after RS-RARP. Patients with immediate urinary continence were significantly younger (66.92 +/- 5.73 vs. 69.68 +/- 4.99 years, p=0.031) than those who were incontinent. Furthermore, the prostate volume was significantly smaller (30.90 vs. 44.60 ml, p=0.001) and preoperative international prostate symptom score (IPSS) was significantly lower (Mild 76.5% vs. 24.0%, Moderate 20.0% vs. 32.0%, and Severe 3.5% vs. 44.0%, p=0.000) in patients with immediate urinary continence compared with those who were not. On univariable regression analysis, patient's age (OR 0.907, p=0.035), prostate volume (OR 0.935, p=0.000), moderate (OR 0.196, p=0.007), and severe IPSS (OR 0.025, p=0.000) (compared with mild IPSS) were independent adverse predictors of immediate urinary continence. On multivariable analysis, prostate volume (OR 0.955, p=0.032) and severe preoperative IPSS (OR 0.044, p=0.000) (compared with mild IPSS) were independent adverse predictors of immediate urinary continence after RS-RARP.Conclusions RS-RARP hastens the recovery of urinary continence after surgery. Prostate volume and severe preoperative IPSS were independent adverse predictors of the return to immediate urinary continence.