经尿道前列腺激光汽化电切术后尿失禁的危险因素分析

Risk factors analysis of urinary incontinence after transurethral excision of the prostate by laser vaporization in patients with benign prostatic hyperplasia

目的 分析良性前列腺增生(BPH)患者经尿道前列腺激光汽化电切(TULP)术后发生尿失禁(UI)的危险因素,为防治UI提供临床依据。方法 回顾性收集2020年7月至2021年7月上饶市人民医院收治的200例行TULP术治疗的BPH患者的临床资料,根据其术后是否发生UI分为UI组(43例)和非UI组(157例)。比较两组的一般资料,通过多因素logistic回归法分析BPH患者TULP术后发生UI的危险因素。结果 多因素logistic回归分析显示,高龄(β=1.372,OR=3.943,95%CI=2.411~6.449,P<0.001)、前列腺体积大(β=2.184,OR=8.882,95%CI=6.084~12.965,P<0.001)、手术时间长(β=1.427,OR=4.166,95%CI=1.483~11.704,P=0.007)、膀胱冲洗液温度低(β=2.342,OR=10.402,95%CI=7.425~14.572,P<0.001)、导尿管气囊注水量大(β=2.583,OR=13.237,95%CI=3.791~46.223,P<0.001)、便秘(β=1.263,OR=3.536,95%CI=1.699~7.360,P<0.001)、无术前盆底肌训练(β=1.735,OR=5.669,95%CI=2.288~14.048,P=0.007)是BPH患者TULP术后发生UI的独立危险因素(P<0.05)。结论 BPH患者TULP术后发生UI的危险因素包括高龄、前列腺体积大、手术时间长、膀胱冲洗液温度低、导尿管气囊注水量大、便秘、无术前盆底肌训练等,临床可据此对BPH患者TULP术后进行治疗及干预,以降低其术后发生UI的风险。

Objective To analyze the risk factors of urinary incontinence(UI)after transurethral excision of the prostate by laser vaporization in patients with benign prostatic hyperplasia(BPH).Methods The clinical data of 200 patients with BPH treated by transurethral excision of prostate by laser vaporization(TULP)from July 2020 to July 2021 in Shangrao People′s Hospital were retrospectively collected.They were divided into the UI group(43 cases)and the non-UI group(157 cases)according to the postoperative UI.The general data of the two groups were compared.The risk factors of UI after TULP in BPH patients was analyzed by multivariate logistic regression.Results Multivariate logistic regression analysis showed that advanced age(β=1.372,OR=3.943,95%CI=2.411-6.449,P<0.001),large prostate volume(β=2.184,OR=8.882,95%CI=6.084-12.965,P<0.001),long operation time(β=1.427,OR=4.166,95%CI=1.483-11.704,P=0.007),low temperature of bladder flushing fluid(β=2.342,OR=10.402,95%CI=7.425-14.572,P<0.001),large volume of catheter balloon injection(β=2.583,OR=13.237,95%CI=3.791-46.223,P<0.001),constipation(β=1.263,OR=3.536,95%CI=1.699-7.360,P<0.001),and no preoperative pelvic floor muscle training(β=1.735,OR=5.669,95%CI=2.288-14.048,P=0.007)were independent risk factors for postoperative UI in BPH patients(P<0.05).Conclusion The risk factors of UI after TULP in BPH patients include advanced age,large prostate volume,long operation time,low temperature of bladder flushing fluid,large volume of catheter balloon injection,constipation,and no preoperative pelvic floor muscle training,etc.According to this,clinical treatment and intervention can be carried out for BPH patients after TULP to reduce the risk of UI after operation.