术前及术后膜性尿道长度与腹腔镜根治性切除术后尿控功能的相关性  

Relationship between membranous urethra length before and after operation and urinary control function after laparoscopic radical prostatectomy

作　　者：郭洪玉 石蕊[1] 曹宇京 Guo Hongyu;Shi Rui;Cao Yujing(Department of Urology,Bejing Friendship Hospital Afflated to Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院泌尿外科,北京100050

出　　处：《国际泌尿系统杂志》2024年第3期498-502,共5页International Journal of Urology and Nephrology

摘　　要：目的:探讨腹腔镜前列腺根治性切除术(LRP)患者术前和术后的膜性尿道长度(MUL)及前列腺体积与尿控功能恢复之间的相关性。方法:回顾性分析2019年6月至2021年12月期间在本院接受LRP治疗的110例前列腺癌患者的临床资料。采用3.0T西门子磁共振仪测量患者的MUL和前列腺体积,评估患者术后1、3、6及12个月的尿控情况。收集并分析患者的基本信息、术前临床指标和术中相关因素,包括年龄、体质量指数(BMI)、前列腺特异性抗原(PSA)水平、Gleason评分、病理分期等。采用logistic回归分析患者术后尿控功能恢复的影响因素。结果:术后1个月时,19.09%(21/110)的患者恢复了尿控功能,术后3个月时增至47.27%(52/110),6个月时为65.45%(72/110),12个月时达到91.82%(101/110)。logistic回归分析结果显示,MUL≥14 mm、膀胱颈保留、后方颈膜重建和前列腺体积均是患者术后尿控功能恢复的独立影响因素(均P<0.05)。MUL≥14 mm的患者在术后早期尿控功能恢复中更为有利,而前列腺体积较大(>50 mL)的患者在尿控功能恢复方面表现较差。结论:在LRP术后,患者尿控功能的恢复受MUL和前列腺体积的显著影响。MUL越长,其尿控制能力越好,而越大的前列腺体积则越不能改善其尿控功能的恢复。Objective To analyze the correlation between preoperative and postoperative membranous urethral length(MUL)and prostate volume with urinary control recovery in patients undergoing laparoscopic radical prostatectomy(LRP).Methods This retrospective study included 110 prostate cancer patients who underwent LRP in our hospital from June 2019 to December 2021.The MUL and prostate volume were measured using a 3.OT Siemens MRI.The urinary control status of patients was evaluated at 1 month,3 months,6 months,and 12 months postoperatively.Basic patient information,preoperative clinical indicators,and intraoperative factors were collected,including age,body mass index(BMI),prostate-specific antigen(PSA)level,Gleason score,and pathological staging.Logistic regression was used to analyze the factors affecting the recovery of urinary control function.Results At 1 month postoperatively,19.09%of patients had regained urinary control,increasing to 47.27%at 3 months,65.45%at 6 months,and reaching 91.82%at 12 months.Analysis using logistic regression methods indicated that membranous urethral length(MUL)≥14 mm,bladder neck preservation and posterior neck membrane reconstruction were key independent factors affecting postoperative urinary control recovery(all P<0.05).Patients with MUL≥14 mm had more favorable early postoperative urinary control recovery,while those with larger prostate volumes(>50 mL)showed poorer outcomes in urinary control recovery.Conclusions After LRP,the recovery of urinary control in patients is significantly influenced by both MUL and prostate volume.Longer MUL is associated with better urinary control,whereas larger prostate volumes do not enhance recovery of urinary control.These findings are of significant guidance for clinicians in assessing postoperative recovery prognosis and in formulating personalized treatment plans.

关 键 词：前列腺肿瘤 前列腺切除术 腹腔镜检查 尿道 控尿功能 

分 类 号：R737.25[医药卫生—肿瘤]