良性前列腺增生患者经尿道前列腺电切术后尿失禁发生情况及影响因素

Incidence and Influencing Factors of Urinary Incontinence after Transurethral Resection of Prostate in Patients with Benign Prostatic Hyperplasia

【目的】探讨经尿道前列腺电切术治疗良性前列腺增生患者术后尿失禁发生情况及影响因素。【方法】回顾性分析2017年1月至2020年1月本院收治的150例行经尿道前列腺电切术治疗的良性前列腺增生患者临床资料,根据患者术后是否出现尿失禁将其分为观察组(发生尿失禁)和对照组(未发生尿失禁)。记录患者术后尿失禁发生情况,比较两组患者一般资料及围术期指标,采用Logistic回归分析术后发生尿失禁的影响因素。【结果】术后1个月,共29例患者出现尿失禁,其中真性尿失禁l例、急迫性尿失禁13例、压力性尿失禁15例;轻度尿失禁20例,中度尿失禁8例,重度尿失禁1例。观察组前列腺切除重量/前列腺体积、前列腺体积、手术时间、术中切除前列腺组织质量、导尿管堵塞率、术后便秘比例、导尿管气囊注水量高于对照组,术前盆底肌训练率低于对照组,差异均有统计学意义(均P<0.05)。多因素Logistic回归分析显示,前列腺体积、年龄、术前盆底肌训练、导尿管气囊注水量是影响行经尿道前列腺电切术治疗的患者术后发生尿失禁的影响因素(P<0.05)。【结论】经尿道前列腺电切术治疗的良性前列腺增生术后尿失禁发生率高,前列腺体积、年龄、术前盆底肌训练、导尿管气囊注水量是患者术后发生尿失禁的影响因素,术前盆底肌训练可降低尿失禁发生风险。

【Objective】To investigate the incidence and influencing factors of postoperative urinary incontinence in patients with benign prostatic hyperplasia treated by transurethral resection of the prostate.【Methods】The clinical data of 150 patients with benign prostatic hyperplasia treated by transurethral resection of prostate from January 2017 to January 2020 were analyzed retrospectively.According to whether the patients had urinary incontinence after operation,they were divided into observation group(with urinary incontinence)and control group(without urinary incontinence).The incidence of postoperative urinary incontinence was recorded,the general data and perioperative indexes of the two groups were compared,and the influencing factors of postoperative urinary incontinence were analyzed by logistic regression.【Results】One month after operation,29 patients had urinary incontinence.There were 1 case of true urinary incontinence,13 cases of urgent urinary incontinence and 15 cases of stress urinary incontinence;There were 20 cases of mild urinary incontinence,8 cases of moderate urinary incontinence and 1 case of severe urinary incontinence.The weight of prostatectomy/volume of prostate,volume of prostate,operation time,mass of prostatectomy tissue during operation,blockage rate of urinary catheter,proportion of postoperative constipation and water injection of urinary catheter balloon in the observation group were higher than those in the control group,and the training rate of pelvic floor muscle before operation was lower than that in the control group(all P<0.05).Multivariate logistic regression analysis showed that prostate volume,age,preoperative pelvic floor muscle training and the amount of water injected into urethral catheter balloon were the influencing factors of postoperative urinary incontinence in patients undergoing transurethral resection of prostate(P<0.05).【Conclusion】The incidence of postoperative urinary incontinence in patients with benign prostatic hyperplasia treated by transurethral resection of the prostate is high.Prostate volume,age,preoperative pelvic floor muscle training and the amount of water injected into the bladder of urinary catheter are the influencing factors of postoperative urinary incontinence.Preoperative pelvic floor muscle training can reduce the risk of urinary incontinence.