Relationship between membranous urethra length before and after operation and urinary con-trol function after laparoscopic radical prostatectomy
Objective To analyze the correlation between preoperative and postoperative mem-branous urethral length(MUL)and prostate volume with urinary control recovery in patients undergo-ing laparoscopic radical prostatectomy(LRP).Methods This retrospective study included 110 pros-tate cancer patients who underwent LRP in our hospital from June 2019 to December 2021.The MUL and prostate volume were measured using a 3.0T Siemens MRI.The urinary control status of patients was evaluated at 1 month,3 months,6 months,and 12 months postoperatively.Basic patient informa-tion,preoperative clinical indicators,and intraoperative factors were collected,including age,body mass index(BMI),prostate-specific antigen(PSA)level,Gleason score,and pathological staging.Logistic regression was used to analyze the factors affecting the recovery of urinary control function.Re-sults At 1 month postoperatively,19.09％of patients had regained urinary control,increasing to 47.27％at 3 months,65.45％at 6 months,and reaching 91.82％at 12 months.Analysis using lo-gistic regression methods indicated that membranous urethral length(MUL)≥14 mm,bladder neck preservation and posterior neck membrane reconstruction were key independent factors affecting postop-erative urinary control recovery(all P＜0.05).Patients with MUL≥14 mm had more favorable early postoperative urinary control recovery,while those with larger prostate volumes(＞50 mL)showed poorer outcomes in urinary control recovery.Conclusions After LRP,the recovery of urinary control in patients is significantly influenced by both MUL and prostate volume.Longer MUL is associated with better urinary control,whereas larger prostate volumes do not enhance recovery of urinary control.These findings are of significant guidance for clinicians in assessing postoperative recovery prognosis and in formulating personalized treatment plans.
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