Meta-analysis of risk factors in urinary incontinence for patients with prostate cancer after radical surgery
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目的:系统评价前列腺癌患者根治术后尿失禁的危险因素.方法:系统检索PubMed、Cochrane Li-brary、Web of Science、Embase、中国知网、维普、万方、中国生物医学文献数据库中有关前列腺癌根治术后尿失禁的危险因素的研究,检索时限为建库至2023年4月.2名研究员使用Endnote 20独立进行文献筛选、数据提取、质量评价后使用Stata 12.0和R 4.3.2进行统计分析.结果:最终纳入17篇文献,结果显示:年龄(OR=1.03,95％CI:1.02～1.05,P＜0.01)、前列腺体积(OR=1.01,95％CI:1.00～1.02,P＜0.05)、病理分期＞T3a(OR=2.69,95％CI:1.88～3.83,P＜0.01)、前列腺手术史(OR=2.81,95％CI:1.93～4.10,P＜0.01)、国际前列腺症状评分(OR=1.03,95％CI:1.02～1.05,P＜0.01)、术前尿失禁(OR=2.86,95％CI:1.95～4.20,P＜0.01)、膀胱功能失代偿(OR=5.09,95％CI:1.10～23.58,P＜0.05)是前列腺癌患者根治术后发生尿失禁的危险因素,术前膜尿道长度(OR=0.74,95％CI:0.58～0.95,P＜0.05)、保留神经(OR=0.45,95％CI:0.27～0.75,P＜0.01)、保留膀胱颈(OR=0.33,95％CI:0.23～0.48,P＜0.01)是前列腺癌患者根治术后发生尿失禁的保护因素.结论:前列腺癌根治术后患者发生尿失禁与患者自身情况、病理相关因素及手术相关因素有关,临床应早期识别高危人群并及时采取干预措施,从而改善患者的预后.
Objective:To systematically evaluate the risk factors in urinary incontinence for prostate cancer pa-tients after radical surgery.Methods:PubMed,Cochrane Library,Web of Science,Embase,CNKI,VIP,Wan-fang and China Biology Medicine Disc were systematically searched for studies on the factors associated with urina-ry incontinence in patients who have undergone radical prostatectomy.The search period was from establishment to April 2023.Literature screening,data extraction,and quality evaluation were performed independently by 2 re-searchers using Endnote 20 followed by statistical analysis using Stata 12.0 and R 4.3.2.Results:A total of 17 articles were included.Age(OR=1.03,95％CI:1.02-1.05,P＜0.01),prostate volume(OR=1.01,95％CI:1.00-1.02,P＜0.05),pathological staging＞T3a(OR=2.69,95％CI:1.88-3.83,P＜0.05),prostate sur-gery history(OR=2.81,95％CI:1.93-4.10,P＜0.01),IPSS(OR=1.03,95％CI:1.02-1.05,P＜0.01),preoperative urinary incontinence(OR=2.86,95％CI:1.95-4.20,P＜0.01),bladder decompensation(OR=5.09,95％CI:1.10-23.58,P＜0.05)served as the risk factors in urinary incontinence for patients following radical prostatectomy.Preoperative membranous urethra length(OR=0.74,95％CI:0.58-0.95,P＜0.05),nerve preservation(OR=0.45,95％CI:0.27-0.75,P＜0.01),bladder neck preservation(OR=0.33,95％CI:0.23-0.48,P＜0.01)served as the protective factors in urinary incontinence for patients following radical pros-tatectomy.Conclusion:Urinary incontinence in patients after radical prostatectomy is related to the patient's own condition,pathology-related factors and surgery-related factors.Clinicians should early identify the high-risk pa-tients and take timely measures to improve the patient's prognosis.
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