基于mpMRI评估机器人辅助腹腔镜根治性前列腺切除术后早期尿控的影响因素  

Analysis of influencing factors of early urinary continence after robot-assisted laparoscopic radical prostatectomy based on mpMRI

作　　者：张泽霖 朱依萍 张家昊 陈家浩 王小海[1] 韩邦旻 ZHANG Zelin;ZHU Yiping;ZHANG Jiahao;CHEN Jiahao;WANG Xiaohai;HAN Bangmin(Department of Urology,Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200080,China)

机构地区：[1]上海交通大学医学院附属第一人民医院泌尿外科,上海200080

出　　处：《机器人外科学杂志（中英文）》2024年第4期499-504,共6页Chinese Journal of Robotic Surgery

基　　金：国家自然科学基金(82072849)。

摘　　要：目的:探讨基于mpMRI评估机器人辅助腹腔镜根治性前列腺切除术后早期尿控的影响因素。方法:选取2019年12月—2020年12月上海交通大学医学院附属第一人民医院35例行机器人辅助腹腔镜根治性前列腺切除术患者。以全天不需要使用尿垫和尿控评分≤7分为尿控功能恢复的标准,对术后早期患者的尿控功能进行随访,分析影响术后早期尿失禁的危险因素。结果:膜部尿道角与机器人辅助腹腔镜根治性前列腺切除术后1周~3个月的尿控功能存在明显相关性,尿道壁厚度与拔除尿管后的即时尿控及术后2周~3个月的尿控功能相关,而前列腺尖部形态则与术后2个月时的尿控情况有关,前列腺长度与术后2周的尿控功能恢复相关,前列腺尖部深度及前列腺尖部深度比则与即刻尿控的恢复显著相关。结论:膜部尿道角、尿道壁厚度、前列腺长度、前列腺尖部形态、前列腺尖部深度及前列腺尖部深度比是机器人辅助腹腔镜根治性前列腺切除术后尿失禁的独立预测因素。Objective:To evaluate the influencing factors of early urinary continence after robot-assisted laparoscopic radical prostatectomy based on mpMRI.Methods:35 patients underwent robot-assisted laparoscopic radical prostatectomy in the Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine from December 2019 to December 2020 were selected.The urinary continence function of the patients in the early postoperative period was followed up,and risk factors affecting early postoperative urinary incontinence were analyzed.Results:The membranous urethral angle was significantly correlated with urinary continence at 1 to 3 months after surgery.The urethral wall thickness was correlated with immediate urinary continence after catheter removal and urinary continence at 2 to 3 months after surgery,while the prostate apex shapes were correlated with urinary continence function at 2 months after surgery,and prostate length was correlated with urinary continence function at 2 weeks after surgery.Prostate apical depth and the ratio of prostate apical depth were significantly correlated with the immediate urinary continence.Conclusion:Membranous urethral angle,urethral wall thickness,prostate length,prostate apex shape,prostate apical depth and prostate apical depth ratio are the influential factors of urinary incontinence after robot-assisted laparoscopic radical prostatectomy.

关 键 词：机器人辅助手术 腹腔镜根治性前列腺切除术 尿失禁 影响因素 

分 类 号：R737.25[医药卫生—肿瘤]