Risk Factors And Predictive Models For Short-term Urinary Incontinence After Radical Prostatectomy For Prostate Cancer

Objectibe: A case-control study was conducted to analyze the clinical data of100 patients undergoing radical prostatectomy,and the incidence of postoperative urinary incontinence was analyzed.The baseline data of patients were collected,and the influencing factors of postoperative urinary incontinence in elderly patients with localized prostate cancer were analyzed through univariate and multivariate analysis.To provide clinical support for early improvement of postoperative urinary control and quality of life of patients;To provide the basis for early urinary control treatment for prostate cancer patients after radical treatment.Methods: Clinical data of 100 hospitalized patients diagnosed with prostate cancer by pathological prostate biopsy and undergoing radical prostatectomy were collected from January 2015 to December2022 in the People’s Hospital of Xinjiang Uygur Autonomous Region,and 3-month follow-up was conducted.Patients were divided into urinary control group and urinary incontinence group according to postoperative urinary incontinence condition.Relevant data of patients were collected: age,body mass index(BMI),prostate cancer stage,Gleason score,preoperative MRI imaging data: prostate volume,membrane urethra length(MUL),PAL.Whether there is urinary tract infection;History of prostate surgery and other data;The risk factors of urinary incontinence after radical prostatectomy were analyzed and the prediction model was established.Results: Among the 100 patients,13 patients with urinary incontinence were followed up,including 10 patients with Mild urinary incontinence.;Severe urinary incontinence in 3 patient;In urinary control group and urinary incontinence group,there was no statistically significant difference in baseline data of age,BMI,TPSA,FPSA,PSA ratio,previous surgical history,urinary tract infection,TNM stage and Gleason score between the two groups(P>0.05).In preoperative MRI imaging,prostate volume(PV)and prostatic urethral length(PL)showed no statistical difference between the two groups.The mean length of membranous urethra(MUL)was 14.16±1.41 mm in the urine control group and 12.46±1.16 mm in the incontinence group.The MUL of the urine control group was longer than that of the incontinence group,and the difference was statistically significant(P<0.05).Pubic commissation-prostatic tip length(PAL)was28.19±0.82 mm in urinary control group and 25.78±0.98 mm in urinary incontinence group,and the difference was statistically significant(P<0.05).In terms of surgical conditions,robot-assisted laparoscopic total prostatectomy,bladder neck preservation,neurovascular bundle preservation,reconstruction,urinary control group was significantly more than urinary incontinence group,the difference was statistically significant(P < 0.05).The negative rate of incisal margin in urinary control group was significantly lower than that in urinary incontinence group,with statistical significance(P<0.05).In multivariate analysis,multivariate analysis indicated bladder neck retention(OR: 0.024 95%CI: 0.001-0.571),reconstruction(OR: 0.014 95%CI: 0.000-0.585),and negative incisal margin(OR:0.00795%CI:0.000-0.239),there was a statistical difference between the two groups(P<0.05).Conclusion:The incidence of short-term urinary incontinence after prostate cancer surgery was 13%.Bladder neck preservation,reconstruction and negative incisal margin are important prognostic factors for urinary control after radical prostatectomy,and are independent of the patient’s basic condition and preoperative MR Parameters.