Risk of Urinary Incontinence Following Prostatectomy: The Role of Physical Activity and Obesity
Risk of Urinary Incontinence Following Prostatectomy: The Role of Physical Activity and Obesity
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DOI：
10.1016/j.juro.2009.09.082
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发表时间：
2010-02-01
影响因子：
6.6
通讯作者：
Kibel, Adam S.
中科院分区：
文献类型：
--
作者：
Wolin, Kathleen Y.;Luly, Jason;Kibel, Adam S.
目的：尿失禁是前列腺癌根治性前列腺切除术最常见和最令人痛苦的副作用之一。几项研究表明，肥胖男性的症状可能更严重，但据我们所知，还没有研究针对肥胖和久坐不动的生活方式的共同影响。我们在接受根治性前列腺切除术的男性样本中评估了肥胖和缺乏体育活动与尿失禁的关系。材料与方法：身高和体重从图表中抽象化，肥胖定义为体重指数大于等于30 kg/m(2)。男性在手术前完成了一份调查问卷，其中包括剧烈运动的自我报告。每周剧烈运动1小时或更长时间的男性被认为是活跃的。男性在泌尿外科就诊时向外科医生报告他们的尿失禁。从术后6周和58周的图表中提取尿失禁的信息。结果：术后6周，59%（405）的男性尿失禁，定义为任何尿垫使用。术后58周，22%（165）的男性出现尿失禁。在58周时，失禁在肥胖和不运动的男性中更为普遍（59%失禁）。体育锻炼可以抵消肥胖的一些负面影响，因为58周时尿失禁的患病率在肥胖和运动（25%失禁）和非肥胖和不运动（24%失禁）的男性中相似。结果最好的是那些不肥胖且经常运动的男性（16%失禁）。不肥胖且运动的男性发生尿失禁的可能性比肥胖且不运动的男性低26% （RR 0.74, 95% CI 0.52-1.06）。结论：前列腺切除术前的运动和肥胖可能是前列腺切除术后尿失禁水平的重要因素。针对前列腺癌患者增加身体活动和减轻体重的干预措施可能通过抵消治疗的负面副作用来改善生活质量。
Purpose: Urinary incontinence is one of the most commonly reported and distressing side effects of radical prostatectomy for prostate carcinoma. Several studies have suggested that symptoms may be worse in obese men but to our knowledge no research has addressed the joint effects of obesity and a sedentary lifestyle. We evaluated the association of obesity and lack of physical activity with urinary incontinence in a sample of men who had undergone radical prostatectomy.Materials and Methods: Height and weight were abstracted from charts, and obesity was defined as body mass index 30 kg/m(2) or greater. Men completed a questionnaire before surgery that included self-report of vigorous physical activity. Men who reported 1 hour or more per week of vigorous activities were considered physically active. Men reported their incontinence to the surgeon at their urology visits. Information on incontinence was abstracted from charts at 6 and 58 weeks after surgery.Results: At 6 weeks after surgery 59% (405) of men were incontinent, defined as any pad use. At 58 weeks after surgery 22% (165) of men were incontinent. At 58 weeks incontinence was more prevalent in men who were obese and physically inactive (59% incontinent). Physical activity may offset some of the negative consequences of being obese because the prevalence of incontinence at 58 weeks was similar in the obese and active (25% incontinent), and nonbese and inactive (24% incontinent) men. The best outcomes were in men who were nonobese and physically active (16% incontinent). Men who were not obese and were active were 26% less likely to be incontinent than men who were obese and inactive (RR 0.74, 95% CI 0.52-1.06).Conclusions: Pre-prostatectomy physical activity and obesity may be important factors in post-prostatectomy continence levels. Interventions aimed at increasing physical activity and decreasing weight in patients with prostate cancer may improve quality of life by offsetting the negative side effects of treatment.