Analysis Of Influencing Factors Of The Recovery Of Urinary Continence After Radical Prostatectomy In Single Center

Objective:Through the collection of clinical data related to radical prostatectomy in the Department of The Affiliated Hospital of Qingdao University,we analyzed the influencing factors of the recovery of urinary continence after radical prostatectomy and provided help for patients consult regarding urinary continence.Methods:We collected the clinical data on 215 patients from January 2018 to May2021 who were diagnosed with prostate cancer by biopsy and treated by radical prostatectomy in the Urology Department of The Affiliated Hospital of Qingdao University,and we retrospectively analyzed the urinary continence at 3,6 and 12 months after radical prostatectomy.Preoperative and postoperative related clinical indicators and data were recorded,including age at operation,body mass index(BMI),hypertension,diabetes,neoadjuvant androgen deprivation therapy,preoperative PSA maximum value,prostate volume(PV),intravesical prostatic protrusion length(IPPL),surgical methods include laparoscopic radical prostatectomy(LRP)and robot-assisted laparoscopic radical prostatectomy(RALP),pathological T stage,postoperative Gleason score,positive surgical margin,pelvic floor muscle training(PFMT).Statistical methods were used to summarize the above data,and SPSS 26.0 was used to analyze the relevant data to assess the relationship between various clinical parameters and data and the recovery of postoperative urinary continence.Results:We included 215 patients in total.Recovery of urinary continence after radical prostatectomy was 137(63.72%),168(78.14%),and 191(88.84%)at 3,6,and 12 months,respectively.Hypertension,neoadjuvant androgen deprivation therapy,preoperative PSA maximum value,surgical methods,pathological T stage,postoperative Gleason score,positive surgical margin,and pelvic floor muscle training were not significantly associated with the recovery of urinary continence after radical prostatectomy.Body mass index(BMI),diabetes,prostate volume(PV)and intravesical prostatic protrusion length(IPPL)were statistically significant in univariate analysis at 3 months after radical prostatectomy.Binary logistic regression analysis including the above factors revealed that BMI≥28 kg/m~2(P<0.01),diabetes(P<0.01)and IPPL≥10 mm(P<0.01)were independent risk factors for urinary incontinence at 3 months after radical prostatectomy.Age at operation,BMI,diabetes,prostate volume,and IPPLwere statistically significant in univariate analysis at 6 months after radical prostatectomy.Binary logistic regression analysis including the above factors revealed that age≥65 years(P=0.011),BMI≥28 kg/m~2(P<0.01),diabetes(P<0.01),PV≥50 ml(P=0.013)and IPPL≥10 mm(P<0.01)were independent risk factors for urinary incontinence at 6 months after radical prostatectomy.BMI,prostate volume,and IPPLwere statistically significant in univariate analysis at 12months after radical prostatectomy.Binary logistic regression analysis including the above factors revealed that BMI≥28 kg/m~2(P<0.01)and IPPL≥10 mm(P<0.01)were independent risk factors for urinary incontinence at 12 months after radical prostatectomy.Conclusion:1.Most patients can achieve urinary continence within 1 year after radical prostatectomy.2.Diabetes is an independent risk factor for urinary incontinence during 3 months and6 months after radical prostatectomy.Diabetes is a disadvantage to the recovery of urinary continence in 3 months and 6 months after radical prostatectomy.3.Age and PV are independent risk factors for urinary incontinence during 6 months after radical prostatectomy.Age≥65 years and PV≥50 ml are disadvantages to the recovery of urinary continence in 6 months after radical prostatectomy.4.BMI and IPPL are independent risk factors for urinary incontinence within 1 year after radical prostatectomy.BMI≥28 kg/m~2 and IPPL≥10 mm are disadvantages to the recovery of urinary continence within 1 year after radical prostatectomy.