腹腔镜前列腺癌根治术后尿失禁与否的尿动力学对比研究

doi:10.3969/j.issn.1000-8535.2016.06.007

广州医药 ›› 2016, Vol. 47 ›› Issue (6): 22-25.DOI: 10.3969/j.issn.1000-8535.2016.06.007

腹腔镜前列腺癌根治术后尿失禁与否的尿动力学对比研究

黎辉欣, 张海滨, 徐文峰, 刘建华

佛山市第一人民医院泌尿外科 (佛山 528000)

收稿日期:2016-08-31 出版日期:2016-11-20 发布日期:2021-12-02

Urodynamic evaluation in men with and without urinary incontinence after laparoscopic radical prostatectomy

Li Huixin, Zhang Haibin, Xu Wenfeng, et al

Department of Urology, The First People's Hospital of Foshan, Foshan Affiliated Hospital of Sun Yat-sen University, Foshan 528000, China

Received:2016-08-31 Online:2016-11-20 Published:2021-12-02

摘要/Abstract

摘要： 目的比较腹腔镜前列腺癌根治术(laparoscopic radical prostatectomy,LRP)后发生尿失禁(postprostatectomy incontinence,PPI)与没有发生PPI的患者在尿动力学上的差异,为临床诊疗提供尿动力学依据。方法对87例LRP术后的患者按术后是否并发PPI分成两组,行尿动力学检查后进行比较分析。结果 PPI组患者术中保留一侧或双侧神经血管束的比例少于非PPI组,且最大尿道闭合压(maximum urethral closure pressure,MUCP)、最大膀胱容量(maximum cystometric capacity,MCC)、排尿时膀胱开口压力和最大逼尿肌压均较非PPI组低。而腹压漏尿点压试验阳性与临床上是否漏尿并不完全相符。多变量回归分析表明,术中保留神经血管束、MUCP和MCC是PPI的相关因素。结论 PPI与LRP术中保留神经血管束、MUCP和MCC独立相关。尿动力学检查能为更精准有效指导临床治疗提供依据。

关键词: 腹腔镜前列腺癌根治术, 尿动力学, 尿失禁

Abstract: Objective To compare the urodynamic parameters in men with and without postprostatectomy incontinence(PPI) after laparoscopic radical prostatectomy(LRP). Methods 87 patients of prostatic carcinoma after LRP were divided into two groups according to have PPI or not. After urodynamic study, the data were collected to find the difference. Results Overall, the proportion of preservation of unilateral or bilateral neurovascular bundles(NVBs) during LRP was lower in PPI group than that in non-PPI group. Besides, the patients in PPI group had lower maximum urethral closure pressure (P=0.04), maximum cystometric capacity (P=0.04), detrusor pressure during opening (P=0.02)and maximum detrusor pressure (P<0.001), as compared with those in non-PPI group. In the multivariate logistic regression, the preservation of unilateral or bilateral NVBs, MUCP and MCC were identified as the related factor with PPI. Conclusion PPI is significantly associated with the preservation of unilateral or bilateral NVBs, MUCP and MCC. Urodynamic test can be used to make the treatment for PPI. It will be more accurate and effective in clinical practice.

Key words: Laparoscopic radical prostatectomy, Urodynamic, Postprostatectomy incontinence

黎辉欣, 张海滨, 徐文峰, 刘建华. 腹腔镜前列腺癌根治术后尿失禁与否的尿动力学对比研究[J]. 广州医药, 2016, 47(6): 22-25.

Li Huixin, Zhang Haibin, Xu Wenfeng, et al. Urodynamic evaluation in men with and without urinary incontinence after laparoscopic radical prostatectomy[J]. Guangzhou Medical Journal, 2016, 47(6): 22-25.

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腹腔镜前列腺癌根治术后尿失禁与否的尿动力学对比研究

Urodynamic evaluation in men with and without urinary incontinence after laparoscopic radical prostatectomy

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