| Research BackgroundProstate cancer(PCa)is one of the common malignant tumors of the male urinary system,accounting for about 15%of all tumors.Its incidence ranks second in male malignant tumors.The annual number of cases is approximately 1.4 million,and the incidence has been increasing in recent years,and is expected to increase to 1.7 million in 2030.There are significant differences in the incidence of prostate cancer.The regions with the highest incidence rates include North America,the Caribbean,and Australia,while East Asia and South Asia have the lowest rates.The incidence of prostate cancer in my country is much lower than that in European and American countries.With the aging of the population,the improvement of people’s living standards and the popularization of prostate cancer screening,the incidence of prostate cancer in my country is on the rise,especially in cities.At present,radical prostatectomy is one of the standard treatment methods for localized prostate cancer.With the popularization of prostate cancer screening methods,the development of imaging techniques such as CT and MRI,and the improvement of prostate puncture techniques,more and more limitations Sexual prostate cancer has to be detected early,and more patients can be treated with surgery.Laparoscopic radical resection of prostate cancer is currently the mainstream surgical procedure for localized prostate cancer.With the development of related anatomy and the improvement of surgical techniques,in most cases the urinary incontinence of patients can be improved or disappeared in a short period of time,and some patients will still experience urinary incontinence after surgery,which seriously affects the quality of life of patients after surgery.Research purposesAt present,the factors affecting urinary control after radical prostatectomy are not fully understood.The purpose of this study is to examine the patient’s own condition(age,smoking,drinking,BMI,past TURP history,etc.),intraoperative conditions(whether robot-assisted laparoscopic surgery,bladder neck preservation,neurovascular bundle(NVB)preservation,and fascial reconstruction)And postoperative levator anus training and other factors retrospectively analyze the related factors of urinary control recovery of patients after radical prostatectomy,so as to better restore the postoperative urinary control function of patients undergoing radical prostatectomy and improve the quality of life of patients.Research methodsIn this study,relevant information was obtained by consulting the clinical data of patients undergoing radical prostatectomy and return visits,and retrospectively analyzed 270 cases of radical prostatic cancer in Henan Province admitted to the First Affiliated Hospital of Zhengzhou University from August 2017 to August 2020.The basic conditions,treatment conditions and postoperative urinary control function of the patients undergoing surgery.According to the postoperative urinary control function recovery,the patients were divided into urinary control group and urinary incontinence group,and SPSS22.0 statistical software was used for data analysis.According to the type of data,the χ2 test and multivariate logistic regression model were selected for analysis.Research resultsAmong the 270 patients undergoing radical prostatectomy,the age ranged from 56 to 78 years,including 130 patients over 70 years old and 140 patients under 70 years old.Among the enrolled patients,125 had a history of smoking and 145 had a history of smoking denial;180 had a history of drinking,and 90 had a history of denial of drinking;patients had a history of TURP 30 people,240 people who denied the history of TURP;BMI ranged from 19.1 kg/m2 to 32.4 kg/m2.There were 42 patients with BMI greater than or equal to 28 kg/m2 and 228 patients with BMI less than 28 kg/m2;181 people used traditional laparoscopy and 89 people used robot-assisted laparoscopic systems;During the operation,97 people had the bladder neck,and 173 people did not save the bladder neck;70 people had the neurovascular bundle during the operation,and 200 people had the neurovascular bundle during the operation;72 people had the fascia reconstruction during the operation,and the fascia reconstruction was not performed(198)people.Postoperative pathological margins were positive for 48 patients,negative for 222 patients,119 patients received levator anus training postoperatively,151 patients did not perform levator anus suspension training postoperatively;137 patients recovered from urinary control one month after surgery,76 patients with mild urinary incontinence,and severe patients with severe urinary incontinence.57 had urinary incontinence,199 had urinary control recovery 3 months after operation,41 had mild urinary incontinence,and 30 had severe urinary incontinence.Research conclusionsThe urinary control rate in the first month and the third month after operation were 50.74%and 73.70%respectively.The urinary control function of the patients showed a gradually better trend with the time.The patients underwent robot assisted laparoscopic surgery(RALP),intraoperative preservation of bladder neck and neurovascular bundle(NVB),intraoperative posterior fascia reconstruction and postoperative regular anal lifting exercise played a positive role in the recovery of urinary control.The past TURP history was the unfavorable factor for the recovery of urinary control.The operation method(RALP and LRP),intraoperative preservation of bladder neck and neurovascular bundle(NVB)played a positive role in the recovery of urinary control There was no significant difference in the positive rate of pathological margin between the two groups.It has reference significance for clinicians and postoperative patients to recover urinary control. |
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