基础医学与临床 ›› 2014, Vol. 34 ›› Issue (10): 1397-1400.

• 研究论文 • 上一篇    下一篇

前列腺癌根治术后压力性尿失禁的发展规律

麦智鹏1,严维刚2,陈健1,张寅生1,黄钟明3,肖河4,纪志刚5,李汉忠6   

  1. 1. 北京协和医院
    2. 中国医学科学院北京协和医学院北京协和医院泌尿外科
    3. 中国医学科学院 北京协和医学院 北京协和医院
    4. 中国医学科学院 北京协和医院
    5. 中国医学科学院 北京协和医学院 北京协和医院
    6. 中国医学科学院 北京协和医学院 北京协和医院泌尿外科
  • 收稿日期:2014-03-10 修回日期:2014-05-26 出版日期:2014-10-05 发布日期:2014-09-25
  • 通讯作者: 严维刚 E-mail:ywgemailbox@sina.com

Urinary incontinence development following laparoscopic radical prostatectomy

  • Received:2014-03-10 Revised:2014-05-26 Online:2014-10-05 Published:2014-09-25
  • Contact: Wei-gang YAN E-mail:ywgemailbox@sina.com

摘要: 目的 探讨不同定义下的前列腺癌根治术后压力性尿失禁随时间的变化规律及其相关因素。方法 2010年3月至2013年11月,由同一术者完成腹腔镜前列腺癌根治术91例。患者年龄51~75岁,平均67岁。术前PSA 0.1~50.8 μg/L,中位数为10.3μg/L;Gleason评分5~8分;TNM分期T1c~T2c。术后10~17 d拔除尿管,分析其术后尿失禁的发生率及发展规律。控尿良好的定义分为不漏尿、有少量尿滴漏但不用尿垫以及每天使用尿垫不超过1张,共3种。结果 随访1~45个月,平均18个月。根据3种不同的定义,术后拔除尿管后控尿率分别为0%、5%和33%,术后1个月为5%、22%和63%,术后3个月为30%、63%和93%,术后6个月为54%、88%和97%,术后12个月为76%、98%和100%。结论 前列腺癌根治术后尿失禁常见,多数在术后6个月内好转。根据严格的控尿定义,近1/4患者在术后1年仍有尿失禁;但若根据宽松的控尿定义,则几乎所有患者均在1年内达到基本控尿。

关键词: 前列腺癌, 根治术, 尿失禁

Abstract: Objective To assay the time-variations and relating factors of Stress Urinary Incontinence (SUI) after radical prostatectomy. Methods During Mar.2010 to Nov.2013, 91 cases of laparoscopic radical prostatectomy were performed by a single surgeon, followed-up over 1 year. Basic information of all cases: the age range was 51~75 years, 67 on average; PSA range before surgery was 0.1~50.8 μg/L, 10.3 μg/L on median; the Gleason score was 6~8; and TNM stage range T1c~T2c. The catheter removal undertook 2 weeks after operation, then analyzed the incontinence rate and development pattern of incontinence after surgery. Urinary continence defined as 3 below conditions: urine leakage free, little leakage without urinal pads or less than 1 pad per day. Results the follow-up visit range 1~45 months, 18 on average. In line with the 3 definitions, urinary continence rate after catheter removal were: 0%, 5% and 33%; 30%, 63% and 93% by 3 months after surgery; 76%, 98% and 100% by 12 months after surgery. Conclusion the SUI after laparoscopic radical prostatectomy is a common, however, the majority of which can improve within 3~6 months after surgery, and reach basic control within 1 year.

Key words: Prostate cancer, Radical prostatectomy, urinary incontinence