北京大学学报（医学版）2024，Vol.56Issue(4)：589-593,5.DOI:10.19723/j.issn.1671-167X.2024.04.007
前列腺癌根治术后远期膀胱过度活动症的危险因素
Analysis of risk factors for long-term overactive bladder after radical prostatectomy
摘要
Abstract
Objective:To analyze the incidence and progression of overactive bladder(OAB)symp-toms following radical prostatectomy for prostate cancer patients and to identify related risk factors.Methods:A retrospective study was conducted on 263 local stage prostate cancer patients who underwent radical prostatectomy at Peking University Third Hospital from January 2013 to May 2017.Clinical base-line information,comprehensive imaging features,perioperative parameters,preoperative urinary control status,pathological diagnosis,and the incidence of OAB within one year postoperatively were collected and analyzed.In the imaging features,two parameters were defined:Bladder wall thickness(BWT)and bladder mucosal smoothness(BMS),which were used to predict the occurrence of OAB.Patients were evaluated based on their clinical baseline characteristics,including age,body mass index(BMI),co-morbidities,and prostate-specific antigen(PSA)levels.The imaging characteristics were assessed using preoperative MRI,focusing on BWT and BMS.Perioperative parameters included operative time,blood loss,and length of hospital stay.The OAB symptoms were assessed using the overactive bladder symptom score(OABSS)and the international prostate symptom score(IPSS).These scores were correlated with the postoperative incidence of OAB.Results:Among the 263 patients who underwent radical prostatecto-my,52(19.8％)exhibited OAB within one year postoperatively.Of the 40 patients with preoperative OAB symptoms,17(42.5％)showed remission postoperatively,while 23(57.5％)had persistent symptoms.Additionally,29 patients developed new-onset OAB,accounting for 55.77％of all postopera-tive OAB cases.Univariate analysis indicated that BWT,BMS,OABSS,and IPSS score were all associ-ated with the occurrence of postoperative OAB.Further multivariate analysis identified BMS as an inde-pendent risk factor for long-term OAB(P＜0.001).Conclusion:Long-term postoperative overactive bladder is a common complication following radical prostatectomy.The findings suggest that preoperative MRI measurements of bladder wall thickness and bladder mucosal smoothness during bladder filling phase can predict the risk of OAB occurrence postoperatively.Identifying these risk factors preoperatively can help in counseling patients about potential complications and in developing strategies to mitigate the risk of developing OAB after surgery.Early detection and management of these parameters might improve the quality of life for patients undergoing radical prostatectomy.关键词
前列腺癌/前列腺切除手术/膀胱过度活动症/危险因素/预测Key words
Prostate cancer/Radical prostatectomy/Overactive bladder/Risk factors/Prediction分类
医药卫生引用本文复制引用
颜野,李小龙,夏海缀,朱学华,张羽婷,张帆,刘可,刘承,马潞林..前列腺癌根治术后远期膀胱过度活动症的危险因素[J].北京大学学报（医学版）,2024,56(4):589-593,5.基金项目
北京大学第三医院临床队列项目C 类(Y65497-04)Supported by Peking University Third Hospital Clinical Cohort Project Type C(Y65497-04) （Y65497-04）
