经尿道刀口变向钬激光前列腺剜除术术后尿失禁的多因素分析  

Multifactor Analysis of Urinary Incontinence after Turning Holmium Laser Enucleation of the Prostate

作　　者：杨华伟[1] 唐汇龙[1] 龙蠡[1] 谭谈[1] 谢海平[1] 蔡蔚[1] 蒋伟平 贺潇 YANG Hua-wei;TANG Hui-long;LONG Li;TAN Tan;XIE Hai-ping;CAI Wei;JIANG Wei-ping;HE Xiao(Department of Urology,the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Changsha 410007,Hunan,China)

机构地区：[1]湖南中医药大学第一附属医院泌尿外科,长沙410007

出　　处：《中国现代手术学杂志》2022年第3期222-227,共6页Chinese Journal of Modern Operative Surgery

基　　金：湖南省卫健委科研项目(202104051076);湖南中医药大学校级课题(2020XJJJ047);湖南省残疾人康复科研项目(2021XK0210);湖南省中医药科研计划项目(D2022073);湖南省普通高等学校教学改革研究项目(HNJG-2021-0602)。

摘　　要：目的比较经尿道刀口变向钬激光前列腺剜除术(turning holmiun laser enucleation of the prostate,THoLEP)与经尿道直射钬激光前列腺剜除术(holmiun laser enucleation of the prostate,HoLEP)治疗良性前列腺增生(benign prostatic hyperplasia,BPH)术后尿失禁的发生率,分析影响术后尿失禁发生的临床因素。方法采用前瞻性、单盲、随机对照研究将120例前列腺增生患者随机分为THoLEP组和HoLEP组,每组各60例。比较两组患者术后尿失禁的发生率,对可能引起尿失禁的危险因素进行进行单因素分析及多因素Logistic回归分析。结果两组术前一般指标无统计学意义(P>0.05);两组均无真性尿失禁发生,THoLEP组术后拔除导尿管后24 h内尿失禁发生率低于HoLEP组,但差异无统计学意义(P>0.05);手术时间≥60 min、前列腺体积≥80 mL、合并有糖尿病等因素是发生术后尿失禁的危险因素。结论两种钬激光解剖性前列腺剜除术治疗BPH近期临床疗效相当。手术时间、前列腺体积及合并糖尿病是影响术后尿失禁的独立危险因素。Objective To compare the incidence of postoperative urinary incontinence between turning holmiun laser enucleation of the prostate(THoLEP)and holmiun laser enucleation of the prostate(HoLEP)for benign prostatic hyperplasia(BPH)and to analyze the influence factors for the occurrence of postoperative uninary incontinence.Methods A prospective analysis was carried out.120 BPH patients were divided into THoLEP group and HoLEP group,with 60 cases for each.The incidence of urinary incontinence was compared between the two groups,and univariate analysis and multivariate logistic regression analysis were performed for the risk factors of urinary incontinence.Results The general preoperative parameters of the two groups had not statistically significance(P>0.05).No complications such as true incontinence occurred in either group,and the value of incontinence of the THoLEP group was less than the HoLEP group,but the difference did not reach statistical significance(P>0.05).Factors such as operation time≥60 min,prostate volume≥80 mL,comorbid diabetes mellitus were the risk factors for developing urinary incontinence.Conclusion The recent clinical outcomes of holmium laser anatomical prostatic enucleation for the treatment of BPH are comparable.Operation time,prostate volume and comorbid diabetes mellitus are the risk factors for developing urinary incontinence.

关 键 词：经尿道刀口变向钬激光前列腺剜除术 解剖性前列腺剜除术 良性前列腺增生 尿失禁 

分 类 号：R699.8[医药卫生—泌尿科学]