Study On The Effect Of Open Retropubic And Laparoscopic Radical Prostatectomy On Recovery Of Urinary Continence

Objective:Systematic retrospective analysis of inpatient medical records and follow-up of patients with prostate cancer who underwent radical prostatectomy in the Department of Urology,Second Hospital of Tianjin Medical University,to compare the recovery of urinary continence in patients with different surgical procedures,thus guidance on the risk of related complications and prevention of urinary incontinence prevention and urinary recovery after prostatectomy.Methods:A systematic review of patients diagnosed with prostate cancer and undergo radical prostatectomy at the Second Hospital of Tianjin Medical University from December 2011 to December 2016 was performed.The procedure included open retropubic radical prostatectomy(ORRP)and laparoscopic radical prostatectomy(LRP),and the patients were divided into the open retropubic prostatectomy group and the laparoscopic prostatectomy group according to the procedure.The age,preoperative serum total prostate specific antigen(TPSA),prostate volume,body mass index(BMI),clinical stage,postoperative pathological stage,surgical margin,intraoperative preservation of neurovascular bundle(NVB)and bladder neck were analyzed.According to the follow-ups of urinary continence recovery on the day of removal of catheter,6 weeks,3 months,6 months,12 months and 24 months after operation,statistical software was used to make statistics and analyze the urinary continence recovery of patients under different operation methods Results:According to the exclusion criteria,285 patients were included in the study,including 207 patients in the ORRP group and 78 patients in the LRP group.The overall median age was 67 years.There was no significant difference in age and BMI between the two groups(P>0.05).There was no significant difference in the prostate volume between the groups according to≤60ml and>60ml(P=0.538>0.05,χ~2=0.379).The preoperative TPSA of the two groups was≤20 ng/ml and>20 ng/ml.There were no statistical differences in the subgroups(P=0.937>0.05,χ~2=0.006);bladder neck retention,126 patients in the ORRP group,and 50 patients in the LRP group.There was no significant difference between the two groups(P=0.617>0.05).,χ~2=0.251);NVB retained ORRP group in 103 patients(49.8%),LRP group in 50patients(64.1%),there were statistical differences between the two data groups(P=0.030<0.05,χ~2=4.688);There was no significant difference in urinary continence between the two groups on the day of the tube(P=0.099>0.05,χ~2=2.726).There was a statistical difference between the 6th week and the 3th postoperative period(P=0.021<0.05,χ~2=5.345)and(P=0.022<0.05,χ~2=5.266);there were no significant differences in urinary continence between the two groups at 6 months,12 months and 24 months after surgery(P>0.05).There was no significant difference in ICIQ-SF scores between patients who retained NVB in the ORRP group and those who retained NVB in the LRP group at 3 months postoperatively(P=0.061>0.05).There were significant differences in the ICIQ-SF scores between the NVB group and the NVB group.(P=0.000),the ORRP group did not retain NVB and the LRP group did not retain NVB patients with ICIQ-SF scores,there was statistical difference(P=0.014<0.05);12 months after surgery,ORRP group and LRP group retained NVB patients There was a statistically significant difference(P=0.000 and P=0.003)compared with the ICIQ-SF score of patients who did not retain NVB.There was no significant difference in the ICIQ-SF score between the ORRP group and the LRP group who retained NVB(P=0.745).Conclusion:1.Whether it is ORRP or LRP,it will lead to a certain degree of PPI,and about 99.0%(205/207)patients of the ORRP group and 96.2%(75/78)of patients LRP group on the day of removal of the urinary catheter showed urinary incontinence.2.As time goes by,the urinary continence of patients after RP can be gradually restored,and the overall urinary continence rate was 86%,88.1%,and 94.0%at 6months,12 months,and 24 months,respectively.3.According to the urinary continence rate and the ICIQ-SF score,the urinary continence recovery was better in the LRP group than in the ORRP group at 6 weeks after surgery and 3 months after surgery.There was no significant difference in urinary continence recovery between the two groups on the day of removal of the urinary catheter,6 months,12 months,and 24 months after surgery,respectively.4.Patients in the ORRP group and LRP group were divided into subgroups,and ICIQ-SF scores were taken at 3 months and 12 months after surgery(after logarithm)Perform a one-way analysis of variance.Whether it is ORRP or LRP,patients with NVB at these two times recover better than those who do not retain NVB.5.Similarly,in the absence of NVB during surgery,the LRP group was more satisfied with urinary continence than the ORRP group at 3 months after surgery,and there was no statistical difference between the two groups at 12 months after surgery.