| Objective: Radical prostatectomy(RP)is currently one of the first choices for the radical treatment of localized prostate cancer,but urinary control and sexual function loss are the most common complications after RP.In the past,doctors and patients tended to focus only on controlling the tumor itself and eliminate the tumor,ignoring these mid-and long-term complications.However,the loss of urinary control and sexual function seriously reduces the quality of life of patients,often causing patients to have negative feelings of inferiority,and even difficult to integrate into social life.As people living standard rise and a higher level of medical technology,people also more and more attention to these in the past to ignore complications,this study aims to through the robot assisted two prostate cancer and prostate cancer radical laparoscopic radical operation of comparative research,discusses two kinds of operative methods for keeping patients postoperative urinary continence function and sexual function,the influence of In order to lay a practical and theoretical basis for the application of RALP in RP in China.Subjects and Methods: All The references included in Pub Med,The Cochrane Library,Web of Science,Google Academic,Wanfang Database,CNKI and VIP database were searched by computer to collect The literature data on The comparison of postoperative urinary control function and sexual function of patients with two surgical procedures.The advantages and disadvantages of the two surgical methods were studied and compared with the urine control function and sexual function of the patients at 1 month,3 months,6 months and 12 months after surgery.Result: Among the 18 studies,8 studies(1102 cases)compared the urinary control function of patients in the two groups one month after surgery,and the results were statistically significant(OR=1.92 95%CI: 1.49-2.47 P =0.08,see Figure 1).Eight studies(1377 cases)compared patients’ urinary control function 3 months after surgery,and the results were statistically significant(OR=2.20 95%CI: 1.75-2.76P=0.07,see Figure 2).Fourteen studies(2810 cases)were performed to compare patients’ urinary control function 6 months after surgery,and the results were statistically significant(OR=1.48 95%CI: 1.22-1.80 P =0.03,see Figure 4).Thirteen studies(2601 cases)compared urinary control function 12 months after surgery,and the results were statistically significant(OR=1.95 95%CI: 1.52-2.50 P=0.43,see Figure 4).There was statistical significance in the 4 groups(P < 0.00001,P < 0.00001,P < 0.0001,P < 0.00001).There was no heterogeneity in the 4 groups,and the fixed effect model was adopted(I~2=43 I~2=47 I~2=47 I~2=2).Of the 18 studies,6 studies(828cases)compared the sexual function of the two groups 3 months after surgery,and the results were statistically significant(OR=2.49 95%CI: 1.47-4.22 P=0.02,see Figure5).Seven studies(1188 cases)compared sexual function 6 months after surgery,and the results were statistically significant(OR=2.11 95%CI: 1.27-3.49 P=0.01,see Figure 6).Nine studies(1480 patients)compared sexual function 12 months after surgery,and the results were statistically significant(OR=2.09 95%CI: 1.36-3.20P=0.001).The three groups of studies were statistically significant(P=0.0007,P=0.0001,P=0.001).Heterogeneity detection was greater than 50% in the three groups of studies,and random effect model was adopted for all of them(I~2=62 I~2=72I~2=47 I~2=69).Conclusions : Compared with laparoscopic radical prostatectomy,robot-assisted radical prostatectomy has a better effect on the retention of urinary control and sexual function of patients.Robotic surgical system has great application value in the field of urology.However,the literature we included did not consist of completely randomized controlled trials,and more high-quality randomized controlled trials are needed for verification. |
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