Factors Influencing The Recovery Of Urinary Control After Da Vinci Assisted Laparoscopic Radical Prostatectomy

Objective: Objective to investigate the change process of urinary control function recovery in 110 patients after Da Vinci assisted laparoscopic radical prostatectomy(RARP),analyze the related factors that may affect the recovery of urinary control,and explore the prevention and treatment of urinary control recovery disorder after RARP.Methods: The clinicopathological data of 110 patients with RARP performed by the same urologist in our hospital from May 2014 to January 2020 were retrospectively analyzed,and the related factors affecting the recovery of postoperative urinary control function were analyzed.All patients were followed up according to the given time after operation,and relevant clinical indicators and data were collected before and after operation,including age at operation,body mass index(BMI),preoperative PSA maximum value,prostate volume,past history of transurethral resection of prostate,postoperative margin pathology,drinking,smoking,preoperative PSA maximum value,postoperative Gleason score,postoperative urinary incontinence The pathological changes of incision margin,NVB retention and regular anal lifting exercise were analyzed.The above data were collected and analyzed to evaluate the postoperative urinary control function.Univariate analysis was used to screen out the factors that may be related to urinary control,and then multivariate analysis was performed to calculate the risk rate.SPSS 20.0 was used to analyze the relevant data.Results: among 110 patients,36 cases had urinary incontinence one month after operation,and the effective urinary control rate was 67.27%,7 cases had urinary incontinence six months after operation,and the effective urinary control rate was93.64%.One month after operation,BMI ≥ 28 kg /m2(or = 5.122,95% CI: 1.642 ～15.978,P = 0.005)increased the rate of postoperative urinary incontinence,regular anal lifting exercise(or = 0.175,95% CI: 0.054 ～ 0.569,P = 0.004)and NVB retention(or =0.078,95% CI: 0.025 ～ 0.243,P = 0.000)could improve the effective urinary control rate;six months after operation,BMI ≥ 28 kg /m2/Results: M2(or = 7.232,95% CI: 1.018 ～51.376,P = 0.048)increased the rate of postoperative urinary incontinence,regular postoperative anal lifting exercise(or = 0.129,95% CI: 0.018 ～ 0.915,P = 0.040)and NVB retention(or = 0.076,95% CI: 0.008 ～ 0.743,P = 0.027)can improve the effective urinary control rate of patients;Conclusion: Most of the patients with urinary incontinence after RARP can recover 3-6 months after operation.Obesity may be an unfavorable factor for early and long-term urinary control after RARP.At the same time,NVB preservation and regular anal lifting exercise may be favorable factors for early and long-term urinary control after operation.