Risk factors of bladder spasm after surgery for benign prostatic hyperplasia and construction of a prediction model for bladder spasm
Objective To explore the risk factors of postoperative bladder spasm in patients with benign pros-tatic hyperplasia,establish a prediction model,and evaluate the predictive value of the model for postoperative bladder spasm in patients with benign prostatic hyperplasia.Methods A total of 183 patients with benign prostatic hyperplasia who underwent surgery in Chengdu Office Hospital of the People's Government of Tibet Autonomous Region from Janu-ary 2021 to January 2024 were retrospectively selected.According to whether the patients had postoperative bladder spasm,they were divided into a control group(n=140)and a spasm group(n=43).The baseline data,perioperative indica-tors,and preoperative urodynamic levels of the two groups were compared.Logistic multivariate regression analysis was used to analyze the independent risk factors of postoperative bladder spasm,and a prediction model was established.Re-ceiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of the prediction model for post-operative bladder spasm in patients with benign prostatic hyperplasia.Results The proportion of patients with preoper-ative anxiety in the spasm group was significantly higher than that in the control group(P<0.05).There was no signifi-cant difference in baseline data such as comorbidities and education levels between the two groups(P>0.05).The propor-tion of patients with postoperative constipation,the temperature of irrigation fluid<30℃,the flow rate of irrigation fluid<60 drops/min or>80 drops/min,operation duration,intraoperative blood loss,and volume of prostate resection in the spasm group were significantly higher than those in the control group(P<0.05).There was no significant difference in the amount of irrigation fluid and indwelling time of urinary catheter between the two groups(P>0.05).The bladder capacity,maximal urinary flow rate(Qmax),and bladder pressure during filling in the spasm group were significantly lower than those in the control group,and the residual urine volume(RUV)level was significantly higher than that in the control group,with statistically significant differences(P<0.05).Logistic regression analysis showed that opera-tion duration,intraoperative blood loss,prostate resection volume,temperature of irrigation fluid<30℃,flow rate of ir-rigation fluid<60 drops/min or>80 drops/min,Qmax,RUV,bladder pressure during filling period,preoperative anxiety,and postoperative constipation were independent influencing factors of bladder spasm after surgery for prostatic hy-perplasia(P<0.05).ROC curve analysis showed that the AUC of the ROC curve of the prediction model for postop-erative bladder spasm in patients with benign prostatic hyperplasia was 0.889,the standard error was 0.027,and the 95%CI was 0.837-0.941,which had a high prediction efficiency.Conclusion Bladder spasm in patients with benign prostatic hyperplasia after surgery is affected by many factors.The prediction model based on the risk factors has a high predictive efficiency.
Prostatic hyperplasiaBladder spasmRisk factorsPrediction modelPredictive value
万方数据
维普
