前列腺增生患者钬激光前列腺剜除术后尿失禁严重程度的影响因素分析

Analysis of influencing factors on the severity of urinary incontinence in patients with prostatic hyperplasia after holmium laser prostatectomy

目的探讨前列腺增生(BPH)患者钬激光前列腺剜除术(HoLEP)后影响尿失禁严重程度的因素。方法选取2019年1月至2021年12月该院行HoLEP治疗的BPH患者263例作为研究对象,收集患者一般资料、术前检查及病史、手术情况等资料,采用国际尿失禁咨询委员会尿失禁问卷简表(ICIQ-SF)评估患者术后3个月尿失禁严重程度,采用单因素分析及多元线性回归分析探究HoLEP后尿失禁严重程度的影响因素。结果术后3个月88例患者发生尿失禁,发生率为33.46%。多元线性回归分析结果显示,术前国际前列腺症状评分(IPSS)>19分[B=0.312,95%CI(0.202~0.422),P<0.001],前列腺体积(PV)>75 mL[B=0.018,95%CI(0.003~0.036),P=0.048]和术前行前列腺穿刺活检术[B=1.631,95%CI(0.294~3.692),P=0.047]是影响患者HoLEP后尿失禁严重程度的独立危险因素,术前IPSS>19分、PV>75 mL及术前行前列腺穿刺活检术的患者ICIQ-SF评分较高。结论术前IPSS>19分、PV>75 mL及术前行前列腺穿刺活检术的患者HoLEP后尿失禁严重程度较高,建议医护人员对于存在以上影响因素的患者应及早干预治疗。

Objective To investigate the factors affecting the severity of urinary incontinence after holmium laser enucleation of the prostate(HoLEP)in patients with prostate hyperplasia(BPH).Methods From January 2019 to December 2021,a total of 263 patients with BPH who underwent HoLEP at this hospital were selected as the research objects,and information on the patients’general data,preoperative examination and medical history,and surgery situation was collected,and the severity of incontinence at three months after surgery was assessed using the International Consultation Committee on Incontinence Questionnaire Short Form(ICIQ-SF).The univariate analysis and multiple linear regression analysis were used to explore the factors affecting the severity of urinary incontinence after HoLEP.Results Urinary incontinence occurred in 88 patients at three months postoperatively,with an incidence of 33.46%.The results of multiple linear regression analysis showed that the preoperative International Prostate Symptom Score(IPSS)>19[B=0.312,95%CI(0.202-0.422),P<0.001],prostate volume(PV)>75 mL[B=0.018,95%CI(0.003-0.036),P=0.048],and preoperative prostate puncture biopsy[B=1.631,95%CI(0.294-3.692),P=0.047]were independent factors influencing the severity of incontinence after HoLEP.The ICIQ-SF score was higher in patients with preoperative IPSS>19,PV>75 mL,and preoperative prostate puncture biopsy.Conclusion Patients with preoperative IPSS>19,PV>75 mL,and preoperative prostate puncture biopsy have a higher severity of urinary incontinence after HoLEP,and healthcare professionals are advised to intervene early in the treatment of patients with these influencing factors.