首页|老年前列腺癌患者前列腺根治术后影响尿控恢复状况的相关因素

老年前列腺癌患者前列腺根治术后影响尿控恢复状况的相关因素

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目的 分析老年前列腺癌患者前列腺根治术后尿控恢复状况的相关因素.方法 选择 2021 年 1 月至 2022 年 9 月中部战区总医院行前列腺根治术治疗的老年前列腺癌患者131例为观察对象,根据术后尿控恢复状况分为尿失禁组(n=46)和尿控组(n=85).比较两组临床资料及围手术期指标,采用多因素logistic回归分析患者前列腺根治术后尿控恢复状况的相关因素.采用SPSS 20.0统计软件进行数据分析.组间比较采用χ2 检验.结果 尿失禁组患者年龄≥75岁、体质量指数(BMI)≥24kg/m2、既往经尿道前列腺电切术(TURP)史、合并高血压史、合并糖尿病史比例明显高于尿控组,差异均有统计学意义(P<0.05).尿失禁组患者术前前列腺体积30~75ml、肿瘤分期≥T3a期、术中出血量≥600 ml比例明显高于尿控组,保留最长尿道长度(MULP)、保留神经血管束(NVB)、完全保留膀胱颈、术后规律提肛训练比例明显低于尿控组,差异均有统计学意义(P<0.05).年龄≥75 岁、既往TURP史、肿瘤分期≥T3a 期、术中出血量≥600 ml 均为前列腺根治术后尿失控的危险因素(OR = 2.451、3.015、2.156、3.074;P<0.05);保留MULP、保留NVB、完全保留膀胱颈、术后规律提肛训练为前列腺根治术后失控的保护因素(OR=0.674、0.845、0.874、0.912;P<0.05).结论 影响前列腺根治术后患者尿控恢复情况的因素多样,其中年龄、既往TURP 史、肿瘤分期、术中出血量均为前列腺根治术后尿失控危险因素,对存在术后尿失禁高危因素患者进行早期干预有助于降低尿失禁发生率.
Factors affecting recovery of urinary control in elderly patients with prostate cancer after radical prostatectomy
Objective To analyze the factors affecting urinary control recovery in the elderly patients with prostate cancer after radical prostatectomy.Methods A total of 131 elderly prostate cancer patients who underwent radical prostatectomy were selected as the observation subjects.They were divided into urinary incontinence group(n=46)and urinary control group(n=85)based on the post-operative recovery of urinary control.The two groups were compared in clinical data and perioperative indicators.Multiple logistic regression analysis was used to analyze the factors affecting the patients' postoperative recovery of urinary control after radical prostatectomy.SPSS 20.0 was used for data analysis.Data comparison between two groups was performed using χ2 test.Results The proportion of patients aged≥75 years,body mass index(BMI)≥24 kg/m2,previous transurethral resection of prostate(TURP),history of hypertension and history of diabetes in the urinary incontinence group were significantly higher than those in the urinary control group,the differences being statistically significant(P<0.05).The proportion of preoperative prostate volume of 30-75 ml,tumor stage≥T3a,and intraoperative bleeding≥600 ml in the urinary incontinence group were significantly higher than those in the urinary control group,but the proportion of the maximum urethral length preservation(MULP),preserved neurovascular bundle(NVB),complete preservation of bladder neck,and regular anal lifting training after surgery were significantly lower than those in the urinary control group,the differences being statistically significant(P<0.05).Age≥75 years,previous TURP history,tumor stage≥T3a,and intraoperative bleeding volume≥600 ml were all risk factors for urinary incontinence after radical prostatectomy(OR= 2.451,3.015,2.156,3.074;P<0.05);MULP,preserved NVB,complete preservation of bladder neck,and regular anal lifting training after surgery were protective factors for urinary incontinence after radical prostatectomy(OR=0.674,0.845,0.874,0.912;P<0.05).Conclusion Various factors affect the recovery of urinary incontinence in the patients after radical prostatectomy,among which age,previous TURP history,tumor staging,and intraoperative bleeding are all risk factors for urinary incontinence after radical prostatectomy.Early intervention in the patients with high-risk factors of postoperative urinary incontinence can help reduce the incidence of urinary incontinence.

agedprostate cancerradical prostatectomyurinary controlfactor

张丽鹏、钱卫红、丁献凡、何叶、韩婷

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中部战区总医院泌尿外科,武汉 430012

老年人 前列腺癌 前列腺根治术 尿控 因素

湖北省卫生健康委员会科研项目

WJ2021Z035

2024

中华老年多器官疾病杂志
中国人民解放军总医院老年心血管病研究所

中华老年多器官疾病杂志

CSTPCD
影响因子:0.728
ISSN:1671-5403
年,卷(期):2024.23(1)
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