The risk factors for urinary function recovery after radical prostatectomy / 中华泌尿外科杂志

ABSTRACT

Objective To investigate the adverse risk factors of urinary function recovery after radical prostatectomy.Methods The clinical data of 126 patients treated with laparoscopic radical prostatectomy from October 2015 to October 2016 were collected and analyzed retrospectively.The mean age was 70 years (48-85 years).The BMI was 16.8-24.7 kg/m2(mean 24.6 kg/m2).The PSA was 1.73-274.5 ng/ml (median 12.06 ng/ml).26 cases had positive surgical margins.There were 62 cases in lower age group (＜70 years) and 64 cases in higher age group(≥70 years).The BMI of the lower age group and the higher age group were (25.35-± 3.66) and (24.00 ± 3.11) kg/m2 (P =0.028).The median PSA of the lower age group and the higher age group were 13.41 and 10.26 ng/ml(P =0.304).The PSA ＜ 10、10-20、＞ 20 ng/ml for two groups were 22,17,20 and 29,18,20 (P =0.41).The Gleason ≤ 6,7,≥ 8scores for two groups were 6,18,38 and 7,24,33 (P =0.168).All patients were followed up for 48 weeks,and the risk factors for patients with poor control of uhnary function were analyzed.Results The overall recovery rate of continence 12 weeks after surgery was 46.8％ (59/126),with lower age group 56.5％ (35/62) and higher age group 37.5％ (24/64) (P ＜0.05).The rate of 24 weeks after surgery was 88.1％ (111/126),with lower age group 93.5％ (58/62)and higher age group 82.8％ (53/64)(P ＜0.05).In a univariate logistic regression test,the age (P =0.034),BMI (P =0.044) and nerve sparing (P =0.005) were associated with recovery of urinary continence within 12 weeks after surgery (P ＜ 0.05).In multivariate logistic regression analysis,age (P =0.011),BMI (P =0.022) and nerve reserved (P =0.014) were independent factors that predicted the recovery of continence within 12 weeks after surgery (P ＜ 0.05).Conclusions Younger age,lower BMI and intraoperative nerve preservation independently predicted recovery of continence within 12 weeks.Age is the influencing factor of continence recovery within 24 weeks.