Prevalence analysis of urinary incontinence after radical prostatectomy and influential preoperative factors in a single institution
Prevalence analysis of urinary incontinence after radical prostatectomy and influential preoperative factors in a single institution
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DOI：
10.1080/13685538.2017.1369944
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发表时间：
2018-01-01
期刊：
影响因子：
2.6
通讯作者：
Pascual, Juan I.
中科院分区：
文献类型：
--
作者：
Tienza, Antonio;Robles, Jose E.;Pascual, Juan I.
目的：评估前列腺癌根治术后尿失禁的发生率，分析患者的术前特点对尿失禁的影响。方法：2002~2012年间，746例临床局限性前列腺癌患者接受根治性前列腺癌根治术。根据国际大陆学会(ICS)对尿失禁的定义：收集康复12个月后非自愿性尿漏的投诉、国际尿失禁咨询问卷(ICIQ-SF)和尿垫/天。评估患者的临床特征和磁共振成像测量。结果：根据ICS的定义，约172例(23%)患者被列为大小便失禁。ICIQ-SF平均值为10.87(4)。17.8%的患者每天至少使用一个衬垫，11.9%的患者/天使用一个以上的衬垫。年龄[OR：1.055；CI 95%(1.006~1.107)，p=.028]、尿道壁厚度[OR：5.03；CI 95%(1.11~22.8)，p=.036]、经尿道前列腺电切史[OR：6.13；CI 95%(1.86~20.18)，p=.003]和尿道膜长度[OR：0.173；CI 95%(0.046~0.64)，p=.009]是影响尿路感染的独立因素。该模型的预测准确率为78.7%，曲线下面积(AUC)值为71.7%。结论：根治性前列腺癌术后尿失禁的发生率因定义不同而不同。年龄、经尿道前列腺电切术(TURP)、尿道膜长度(MUL)、尿道壁厚度(UWT)是高危因素。
Aims: To assess prevalence of urinary incontinence (UI) after radical prostatectomy (RP) and to analyze which preoperative characteristics of the patients have influence on UI.Methods: Between 2002 and 2012, 746 consecutive patients underwent RP for clinically localized prostate cancer. We defined UI according to International Continence Society (ICS) definition: the complaint of any involuntary leakage of urine after 12months of recovery, international consultation on incontinence questionnaire (ICIQ-SF) and pads/day was collected too. Clinical features and magnetic resonance imaging measurements were assessed. A multivariable logistic regression model predicting incontinence were built-in after adjust by cofounding factors and bootstrapping.Results: About 172 (23%) of the patients were classified as incontinent according to the ICS definition. The mean value of the ICIQ-SF was 10.87 (4). 17.8% of patients use at least one pad/day, 11.9% use more than one pad/day. The preoperative factors independently influential in UI are: age [OR: 1.055; CI 95% (1.006-1.107), p=.028], urethral wall thickness [OR: 5.03; CI 95% (1.11-22.8), p=.036], history of transurethral resection of the prostate [OR: 6.13; CI 95% (1.86-20.18), p=.003] and membranous urethral length [OR: 0.173; CI 95% (0.046-0.64), p=.009]. The predictive accuracy of the model is 78.7% and the area under the curve (AUC) value 71.7%.Conclusions: Urinary incontinence after radical prostatectomy has different prevalence depending on the definition. Age, prior transurethral resection of the prostate (TURP), membranous urethral length (MUL) and urethral wall thickness (UWT) were risk factors.