前列腺癌根治术后膀胱壁重建新尿道的功能学评价  

Functional evaluation of bladder wall reconstruction neourethra after radical prostatectomy

作　　者：赵杰[1,2] 官正辉 王江平 ZHAO Jie;GUAN Zhenghui;WANG Jiangping(Department of Urology,Taizhou People's Hospital Affiliated to Nanjing Medical University,Jiangsu Taizhou 225300,China;Graduate School of Dalian Medical University,Liaoning Dalian 116041,China.)

机构地区：[1]南京医科大学附属泰州市人民医院泌尿外科,江苏泰州225300 [2]大连医科大学研究生院,辽宁大连116041

出　　处：《现代肿瘤医学》2024年第15期2801-2806,共6页Journal of Modern Oncology

基　　金：南京医科大学泰州临床医学院临床研究项目(编号:TZKY20220210)。

摘　　要：目的:采用静态尿道闭合压力(static urethral closure pressure, SUCP)测定评价前列腺癌根治术后膀胱壁重建新尿道(bladder wall reconstuction neourethra, BWN)的控尿功能。方法:选取该院2022年03月到2023年04月的53例局限性前列腺癌患者,行采用BWN技术的机器人辅助腹腔镜下前列腺癌根治性切除术(robot-assisted laparoscopic radical prostatectomy, RARP),拔除尿管后1个月、6个月行SUCP测定,测最大尿道闭合压(maximum urethral closure pressure, MUCP)、功能尿道长度(functional urethral length, FUL)、尿道闭合面积(urethral functional pressure area, UFA),分析评价SUCP的特点。结果:53例患者拔除尿管后1个月,尿控48例,尿失禁5例,控尿率为90.57%。均行SUCP测定,尿控组BWN均形成明显峰状曲线,与膜部尿道压力曲线形成典型的双峰,尿失禁组SUCP曲线呈低平双峰。尿控组和尿失禁组的FUL为(27.6±5.1)mm vs (26.0±8.9)mm,两组间无明显差异(P>0.05);MUCP和UFA分别为(63.0±18.9)cmH_(2)O vs (31.4±8.6)cmH_(2)O、(729.0±244.5)mm×cmH_(2)O vs (314.2±66.3)mm×cmH_(2)O,尿控组均明显高于尿失禁组(P<0.05)。结论:BWN明显延长FUL,增加UFA,改善了前列腺癌根治术后早期尿控。Objective:To evaluate the continence function of bladder wall reconstruction neourethra(BWN)after radical prostatectomy for prostate cancer using static urethral closure pressure(SUCP)measurements.Methods:Fifty-three patients with localized prostate cancer who underwent robot-assisted laparoscopic radical prostatectomy(RARP) with BWN technique between March 2022 and April 2023 in the hospital were selected.SUCP measurements including maximum urethral closure pressure(MUCP),functional urethral length(FUL),and urethral functional pressure area(UFA) were performed at 1 month and 6 months after removal of the catheter.The characteristics of SUCP were analyzed and evaluated. Results: At 1 month after catheter removal,48 patients achieved continence while 5 patients experienced urinary incontinence,resulting in a continence rate of 90.57%.SUCP measurements were obtained for all patients.In the continence group,a distinct peak-shaped curve was observed in the SUCP measurement,forming a typical double peak with membranous urethral pressure curve.In the incontinence group,the SUCP curve showed a flattened double peak.The FUL of the urinary control group and urinary incontinence group were (27.6±5.1)mm vs (26.0±8.9)mm,respectively,with no significant difference between the two groups( P >0.05).The MUCP and UFA respectively were (63.0±18.9)cmH_(2)O vs (31.4±8.6)cmH_(2)O,(729.0±244.5)mm×cmH_(2)O vs (314.2±66.3)mm×cmH_(2)O.The urinary control group was significantly higher than the urinary incontinence group( P <0.05). Conclusion: BWN significantly prolongs FUL,increases UFA,and improves early continence after radical prostatectomy for prostate cancer.

关 键 词：膀胱壁重建新尿道 前列腺癌根治性切除术 尿失禁 功能 尿道压 

分 类 号：R737.25[医药卫生—肿瘤]