膀胱镜下尿道前壁加强法对前列腺癌根治术后尿控的影响

Effect of anterior urethral wall reconstruction on urinary control after radical prostate cancer

目的探讨膀胱镜下尿道前壁加强对前列腺癌根治术后尿控的影响。方法回顾性分析2018年5月至2020年8月江苏省南通市第一人民医院收治的80例前列腺癌患者的临床资料,根据治疗方法将患者分为观察组34例(术中采用尿道前壁加强法)和对照组46例(术中采用尿道前后壁加强法),收集两组临床资料、评估前列腺体积、病理分期、Gleason评分及病理分期,同时通过电话随访术后1、3、6及12个月的尿控恢复情况,分析两组患者上述资料的差异性。结果观察组手术时间、术中出血量、尿道重建时间及留置导尿时间少于对照组,前列腺体积大于对照组,差异有统计学意义(P<0.05);两组术后并发症发生率比较,差异无统计学意义(P>0.05);观察组术后1个月尿控恢复率高于对照组,差异有统计学意义(P<0.05),但两组3、6及12个月尿控恢复率比较,差异无统计学意义(P>0.05)。结论膀胱镜下尿道前壁加强对术后早期尿控恢复较好,并且可能缩短手术时间及术中出血,术式的选择可能受前列腺体积的影响。

Objective To explore the effect of anterior urethral wall reconstruction on urinary control after radical prostate cancer.Methods Clinical data of 80 prostate cancer patients admitted to Nantong First People’s Hospital of Jiangsu Province from May 2018 to August 2020 were retrospectively analyzed,according to the treatment methods,the patients were divided into observation group 34 cases(anterior wall strengthening method)and control group 46 cases(anterior and posterior wall strengthening method).The clinical data of the two groups were collected,and the prostate volume,pathological stage,Gleason score and pathological stage were evaluated.At the same time,the recovery of urinary control at 1,3,6,and 12 months after operation was followed up by telephone,and the difference of the above data between the two groups was analyzed.Results Operation time,intraoperative blood loss,urethral reconstruction time of urethral reconstruction time,and indwelling catheterizationin time in observation group were significantly shorter than those in control group,while prostate volume in observation group was significantly larger than control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of postoperative complications between the two groups(P>0.05);the recovery rate of urinary control one month after operation in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05),but there was no significant difference in the recovery rate of urinary control 3,6 and 12 months after operation between the two groups(P>0.05).Conclusion Enhancing the anterior wall of the urethra under cystoscopy can improve the recovery of early postoperative urinary control,and may shorten the operation time and intraoperative bleeding.The choice of surgical procedure may be affected by the volume of the prostate.