摘要
目的分析腹腔镜前列腺癌根治术后病人早期尿控的影响因素。方法2017年1月~2021年6月接受腹腔镜前列腺癌根治术治疗的前列腺癌病人37例,回顾性分析37例前列腺癌病人的临床资料,统计病人腹腔镜前列腺癌根治术后1个月内的早期尿控情况。根据病人术后是否发生尿失禁将病人分为尿失禁组、尿控组,比较尿失禁组与尿控组病人的临床资料,对导致腹腔镜前列腺癌根治术后早期尿控不力的危险因素进行单因素分析、多因素Logistic回归分析。结果37例病人中,14例病人在术后1个月内发生尿失禁,其尿控不力,其余23例病人尿控成功,早期尿失禁率、尿控率分别为37.84%、62.16%。在单因素分析中,尿失禁组与尿控组病人在年龄、体质量指数、术前前列腺体积、肿瘤分期、既往经尿道前列腺电切手术史、术中出血量、完整保留膀胱颈等方面比较,差异均有统计学意义(P<0.05),而尿失禁组与尿控组病人在术前前列腺特异抗原、术前Gleason评分、手术时间、手术入路、盆腔淋巴结清扫、远端尿道保留等方面比较,差异均无统计学意义(P>0.05)。经多因素Logistic回归分析,年龄≥60岁、体质量指数≥24 kg/m^(2)、术前前列腺体积≥30 cm^(2)、肿瘤分期≥T3a期、既往有经尿道前列腺电切手术史、术中出血量≥600 ml、未完整保留膀胱颈是导致腹腔镜前列腺癌根治术后早期尿控不力的危险因素(P<0.05)。结论前列腺癌病人在腹腔镜前列腺癌根治术后早期尿控不力,主要与年龄、体质量指数、术前前列腺体积、肿瘤分期、既往经尿道前列腺电切手术史、术中出血量、是否完整保留膀胱颈等因素有关。
Objective To study and analyze the influencing factors of early urinary control in patients after laparoscopic radical prostatectomy.Methods From January 2017 to June 2021,37 cases of patients with prostate cancer who received laparoscopic radical prostatectomy in our hospital were selected as the research objects.The clinical data of 37 cases of patients with prostate cancer were analyzed retrospectively,and the early urine control of patients with prostate cancer within one month after laparoscopic radical prostatectomy was counted.Patients with prostate cancer were divided into urinary incontinence group and urinary control group according to whether urinary incontinence occurred after laparoscopic radical prostatectomy.The clinical data of patients with urinary incontinence group and urinary control group were compared,and the risk factors leading to poor early urinary control after laparoscopic radical prostatectomy were analyzed by univariate analysis and multivariate Logistics regression analysis.Results Among the 37 cases of patients with prostate cancer,14 cases of patients had urinary incontinence within one month after laparoscopic radical prostatectomy,and their urine control was ineffective.The other 23 cases of patients were successful in urine control,and the early urinary incontinence rate and urine control rate were 37.84%and 62.16%,respectively.In univariate analysis,there were significant differences between urinary incontinence group and urinary control group in age,body mass index,preoperative prostate volume,tumor stage,history of transurethral resection of prostate,intraoperative blood loss,and complete preservation of bladder neck(P<0.05).However,there were no differences between urinary incontinence group and urinary control group in preoperative prostate specific antigen,preoperative Gleason score,surgical time,surgical approach,pelvic lymph node dissection,and bladder neck preservation(P>0.05).According to multivariate Logistics regression analysis,age≥60 years,body mass index≥24 kg/m^(2),preoperative prostate volume≥30 cm^(2),tumor stage≥T3 a,previous history of transurethral resection of prostate,intraoperative blood loss≥600 ml and incomplete retention of bladder neck were the risk factors leading to poor early urinary control after laparoscopic radical prostatectomy(P<0.05).Conclusion Patients with prostate cancer have poor urine control in the early stage after laparoscopic radical prostatectomy,which is mainly related to age,body mass index,preoperative prostate volume,tumor stage,previous history of transurethral resection of prostate,intraoperative blood loss,intact bladder neck and other risk factors.
作者
高雪松
贾卓敏
王毅
赵豫波
徐衍盛
GAO Xuesong;JIA Zhuomin;WANG Yi(Senior Department of Urology,the Third Medical Center of PLA General Hospital,Beijing 100088,China)
出处
《临床外科杂志》
2021年第12期1174-1177,共4页
Journal of Clinical Surgery
关键词
前列腺癌
腹腔镜前列腺癌根治术
尿失禁
尿控
危险因素
prostate cancer
laparoscopic radical prostatectomy
urinary incontinence
urine control
risk factor
