Preoperative Membranous Urethral Length Measurement and Continence Recovery Following Radical Prostatectomy: A Systematic Review and Meta-analysis.
Preoperative Membranous Urethral Length Measurement and Continence Recovery Following Radical Prostatectomy: A Systematic Review and Meta-analysis.
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DOI：
10.1016/j.eururo.2016.06.023
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发表时间：
2017-03
期刊：
影响因子：
23.4
通讯作者：
Patel MI
中科院分区：
文献类型：
--
作者：
Mungovan SF;Sandhu JS;Akin O;Smart NA;Graham PL;Patel MI
在根治性前列腺切除术(RP)前测量的膜性尿道长(MUL)已被确认为与术后大小便恢复有关的一个因素。对所有报道MUL对RP术后大小便恢复的影响的研究进行系统的综述和荟萃分析。对截至2015年9月的PubMed、EMBASE和Scope us数据库进行了全面搜索。包括一项随机对照试验和12项队列研究的13项研究被选为纳入。报告风险比结果的四项研究(1738名患者)。MUL每多出毫米(Mm)与更快地恢复可控有关(危险比：1.0 5；95%可信区间[CI]：1.0 2-1.0 8，p<；0.001)。11项研究(6993名患者)报告了术后一个或多个时间点恢复大小便的OR(OR)。MUL对术后3个月(OR：1.0 8，95%CI：1.0 3~1.14，p=0.004)、6个月(OR：1.12，95%CI：1.0 9~1.15，p<；0.0001)均有显著的促进作用。术后12个月(OR：1.12，95%CI：1.03~1.22，P=0.006)。在调整了重复测量和重叠数据的研究后，所有OR数据合并后表明，每多一毫米的MUL与明显更大的可控性相关(OR：1.0995%CI：1.051.15，p<；0.001)。较大的术前MUL与男性RP术后大小便恢复呈显着正相关。建议先对MUL进行磁共振成像检查，再进行RP检查。我们研究了一段尿路(称为膜性尿路)的长度对前列腺癌根治术后大小便恢复的影响。我们的结果表明，术前通过磁共振成像测量膜性尿路的长度可能有助于预测术后较长时间的尿失禁，或者解释手术后实现可控性延迟的原因。
Membranous urethral length (MUL) measured prior to radical prostatectomy (RP) has been identified as a factor that is associated with the recovery of continence following surgery. To undertake a systematic review and meta-analysis of all studies reporting the effect of MUL on the recovery of continence following RP. A comprehensive search of PubMed, EMBASE, and Scopus databases up to September 2015 was performed. Thirteen studies comprising one randomized controlled trial and 12 cohort studies were selected for inclusion. Four studies (1738 patients) that reported hazard ratio results. Every extra millimeter (mm) of MUL was associated with a faster return to continence (hazard ratio: 1.05; 95% confidence interval [CI]: 1.02–1.08, p < 0.001). Eleven studies (6993 patients) reported the OR (OR) for the return to continence at one or more postoperative time points. MUL had a significant positive effect on continence recovery at 3 mo (OR: 1.08, 95% CI: 1.03–1.14, p = 0.004), 6 mo (OR: 1.12, 95% CI: 1.09–1.15, p <0.0001). and 12 mo (OR: 1.12, 95% CI: 1.03–1.22, p = 0.006) following surgery. After adjusting for repeated measurements over time and studies with overlapping data, all OR data combined indicated that every extra millimeter of MUL was associated with significantly greater odds for return to continence (OR: 1.09, 95% CI: 1.05–1.15, p <0.001). A greater preoperative MUL is significantly and positively associated with a return to continence in men following RP. Magnetic resonance imaging measurement of MUL is recommended prior to RP. We examined the effect that the length of a section of the urethra (called the membranous urethra) had on the recovery of continence after radical prostatectomy surgery. Our results indicate that measuring the length of the membranous urethra via magnetic resonance imaging before surgery may be useful to predict a longer period of urinary incontinence after surgery, or to explain a delay in achieving continence after surgery.
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影响因子：
6.3
作者：
Downs, SH;Black, N
通讯作者：
Black, N
影响因子：
3.7
作者：
Dahl, Sigrun;Loge, Jon Havard;Fossa, Sophie Dorothea
通讯作者：
Fossa, Sophie Dorothea
影响因子：
6.6
作者：
Gudziak, MR;McGuire, EJ;Gormley, EA
通讯作者：
Gormley, EA
影响因子：
6.6
作者：
Holm, Henriette Veiby;Fossa, Sophie D.;Dahl, Alv A.
通讯作者：
Dahl, Alv A.
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N