摘要
目的:探讨腹腔镜根治性前列腺切除术后尿控恢复的影响因素。方法:回顾性分析2011年3月~2014年3月由我院同一术者完成的腹腔镜根治性前列腺切除术的162例患者临床资料。分析患者的尿控恢复情况及影响因素。结果:本组患者拔除尿管后即刻尿控率达8.64%(14/162),1个月达20.37%(33/162),3个月达53.09%(86/162),12个月达97.53%(158/162)。术后3个月,BMI≥28kg/m^2(OR=0.189,95%CI:0.047~0.670,P=0.019)降低术后尿控率,保留膀胱颈部(OR=1.125,95%CI:1.009~9.404,P=0.048)、最长尿道保留技术(OR=37.582,95%CI:8.974~157.385,P<0.001)、保留神经血管束(OR=13.206,95%CI:3.812~45.749,P<0.001)、后方筋膜重建技术(OR=14.729,95%CI:4.048~53.590,P<0.001)显著提高尿控率;术后12个月,BMI≥28kg/m^2降低术后尿控率(OR=0.085,95%CI:0.009~0.841,P=0.035)。结论:腹腔镜根治性前列腺切除术中保留膀胱颈部、保留神经血管束、后方筋膜重建、保存最长尿道能够提高早期尿控,但与患者远期尿控恢复无关。肥胖不利于腹腔镜根治性前列腺切除术后尿控恢复。
Objective：To explore the influencing factors associated with urinary continence following laparoscopic radical prostatectomy.Method：A retrospective study of 162patients＇ data from March 2011 to March 2014 who were confirmed prostate cancer and underwent laparoscopic radical prostatectomy in First Affiliated Hospital of Fujian Medical University.A close follow-up of urinary continence was performed to analyze influencing factors of postoperative urinary continence,and the risk rate was calculated.Result：In this study,postoperative immediate urine continence was 8.64%（14/162）,20.37%（33/162）at 1 month,53.09%（86/162）in 3 months and97.53%（158/162）in 12 months after the surgery.BMI≥28kg/m^2（OR=0.189,95%CI：0.047-0.670,P =0.019）reduced the postoperative continence rate,but preserving bladder neck（OR=1.125,95%CI：1.009-9.404,P =0.048）,maximal urethral length（OR=37.582,95%CI：8.974-157.385,P〈0.001）,the neurovascular bundle（OR=13.206,95%CI：3.812-45.749,P〈0.001）,and reconstruction of the rear fascia（OR=14.729,95%CI：4.048-53.590,P〈0.001）significantly improved continence rates in 3month after the surgery.In 12 month after the surgery BMI≥28kg/m^2（OR=0.085,95%CI：0.009-0.841,P =0.035）reduced the postoperative continence rate.Conclusion：Preserving the bladder neck,the maximal urethral length,the neurovascular bundle and reconstruction of the rear fascia may significantly improved early continence rates in the laparoscopic radical prostatectomy.However,these factors don＇t affect the long-term urinary continence.Obesity is a disadvantage to urinary continence following laparoscopic radical prostatectomy.
出处
《临床泌尿外科杂志》
2016年第10期903-906,共4页
Journal of Clinical Urology
关键词
前列腺癌
腹腔镜下前列腺癌根治术
尿失禁
尿控
prostate cancer
laparoscopic radical prostatectomy
urinary incontinence
urinary continence
