Correlative Factors Of Urinary Incontinence After Radical Prostatectomy

Background:In recent years,due to the enhanced awareness of the human body in the country,the popularization of prostate-specific antigen(PSA)screening and the maturity of systemic prostate biopsy technology,early diagnosis of prostate cancer has been achieved while providing earlystage localized prostate cancer(PCa)patients The timing of surgery to cure the tumor.For prostate cancer patients who are in good health and have a life expectancy of more than 10 years and are relatively localized,radical prostatectomy(RP)is currently the best treatment option.Due to the wide application of laparoscopic techniques in clinical practice,surgeons’ surgical experience and skills are continuously improved,which can reduce surgical trauma and reduce the effect of surgical complications.Laparoscopic radical prostatectomy(LRP)has advantages over traditional open surgery such as minimally invasive surgery,clearer intraoperative vision,and wider operating space.It has become the standard of PCa treatment.Nevertheless,due to the local variation of prostate cancer tumors and individual differences in patients,complications that may occur after LRP afflict the surgeon and patients,such as severe bleeding,postoperative erectile dysfunction,urinary incontinence,bladder urethral anastomotic stenosis Etc.Among them,postoperative urinary incontinence(UI)is one of the most commoncomplications of laparoscopic radical prostatectomy,which severely affects postoperative outcomes and patient satisfaction with surgery.Purpose:This article aims to explore the impact of postoperative radical prostatectomy urinary incontinence related factors for the prevention and treatment of clinical work in the future Methods:Retrospective analysis of 45 patients with localized prostate cancer(PCa)who were admitted to the hospital from October 2015 to September2017 in Jilin University’s China-Japan Union Friendship Hospital.The surgery was performed by the same surgeon and completed follow-up after surgery.After 6 months and 12 months of urinary control,univariate analysis was performed on the possible factors,and a single factor logistic regression analysis was performed.All data were processed using SPSS 21.0 statistical software.Results:1.In the present study,45 patients with PCa underwent laparoscopic radical prostatectomy,followed by monitoring and return visits to patients with urinary incontinence.Indwelling urethral catheterization time was1-2 weeks.All patients had stress urinary incontinence after 1 week of catheter removal.Ten(22.23%)patients recovered urine control within one month and only one patient(2.22%)had complete urinaryincontinence.22 postoperative recovery(48.89%)within 3 months after operation,16(84.44%)newly recovered urine control from 3 months to 6months after surgery,and 43 patients(95.54%)within 1 year postoperatively Can restore basic urine control2.At 1 month after surgery,there was a statistically significant difference in BMI,size of prostate volume,retention of bladder neck,and preservation of neurovascular bundles(P<0.05);at 3 months postoperatively,age,BMI,size of prostate,and whether Preserving the bladder neck and maintaining the neurovascular bundles had statistically significant differences(P<0.05).At the 12 th month after surgery,there was a statistically significant difference in the shape of the overlying tip of the prostate tip(P<0.05).Logistic multivariate regression analysis showed that age≥70,prostate volume>50ml,no prostatic apical coverage before and after the membranous urethra,and unreserved bladder neck and neurovascular bundle during surgery were risk factors for urinary incontinence after LRP(P < 0.05).).The retention of bladder neck and retention of neurovascular bundles did not increase the positive rate of surgical margins(P>0.05).Conclusion:1.RP urinary incontinence recovery has a time correlation.Some patients after radical prostatectomy can gradually resume urine control within 1 to 3 months after surgery.The recovery of urine control is fastestduring the first half of the year.Most patients within 1 year can resume urinary control better.2.Patients with BMI <28,prostate volume <50 ml,retained bladder neck,and neurovascular bundles can significantly improve early urinary control,but are not significantly associated with long-term urinary control.Age <70 years,no front and rear tip of the membranous urethra is conducive to the recovery of long-term urine control after RP.3.Preservation of bladder neck and vascular nerve bundles does not increase the positive rate of surgical margins.