| Objective:To investigate the risk factors of stress urinary incontinence(SUI)after transurethral thulium laser enucleation of the prostate(Tm LEP),and to provide reference for the prevention and treatment of stress urinary incontinence after Tm LEP.Methods:The data of 83 patients who underwent transurethral thulium laser enucleation of the prostate from July 2021 to October 2022 in the Urology Department of Dalian Central Hospital were retrospectively analyzed.The relevant clinical data of patients were searched and recorded in detail through the hospital system,and they were divided into SUI group and non-SUI group according to whether SUI occurred after operation.The clinical data of the two groups of patients were recorded,including:(1)General characters,such as age,body mass index(BMI),smoking history,diabetes,hypertension,history of anticoagulant drugs,etc.;(2)Preoperative indicators,such as preoperative prostate volume,international Prostate Symptom Score(IPSS),total prostate specific antigen(t-PSA),preoperative indwelling catheter,prostate biopsy,etc.;(3)Intraoperative indicators,such as operation time,intraoperative blood loss,etc.;(4)Postoperative indicators,such as the time of indwelling catheter,the amount of water injected into the catheter balloon,and the occurrence of other surgical complications.The SPSS statistical software was used to analyse the clinical data of the patients,and the above-mentioned data were analyzed by univariate analysis,and the factors with statistical significance were analyzed by multivariate Logistic regression analysis to study the related risk factors of stress urinary incontinence after Tm LEP.Results:A total of 83 BPH patients were included in this study,all of whom were treated with transurethral thulium laser enucleation of the prostate,including 69 in the non-SUI group and 14 in the SUI group.The age was 72.65±7.82 years old,ranging from56 to 96 years old,including 33 people younger than 70 years old,and 50 people older than 70 years old;BMI was 24.12±3.39kg/m2,ranging from 16.80～31.38kg/m2;17patients who smoked or had a history of smoking 66 patients without smoking history;12 patients with diabetes mellitus and 71 patients without diabetes mellitus;32 patients with hypertension and 51 patients without hypertension;There were 72 patients with coagulation drugs;the prostate volume was 71.49±32.62,ranging from 20.82 to 167.99ml;the IPSS score was 26.00±3.79,ranging from 15 to 33 points;the average t-PSA was8.93±8.91ng/ml,ranging from 0.33 to 54.88ng/ml ml;39 cases had indwelling catheters before operation,44 cases did not;15 cases underwent prostate biopsy before operation,68 cases did not undergo prostate biopsy;the average operation time was129.89±52.54 min,ranging from 35 to 270min;The intraoperative blood loss was284.10±222.79 ml,ranging from 15 to 880ml;the duration of indwelling catheter was5.41±2.20 days,ranging from 1 to 9 days;There were 8 patients with bladder spasm,the incidence rate was 9.64%,5 patients with postoperative hemorrhage,the incidence rate was 6.02%,and 1 case was re-admitted to hospital with urinary tract infection,the incidence rate was 1.20%.There were 71 patients with complications.The results of univariate analysis showed that: BMI,smoking,hypertension,anticoagulant drug history,IPSS score,t-PSA,preoperative indwelling catheter,prostate puncture,intraoperative blood loss,indwelling catheterization in SUI group and non-SUI group There was no statistically significant difference in catheter time(P>0.05);there were statistically significant differences in age,diabetes,prostate volume,operation time,and water injection volume of catheter balloon(P<0.05).The results of multivariate logistic analysis showed that age,diabetes mellitus,prostate volume,and operation time were correlated with SUI after Tm LEP.Conclusions:Higher age,typeⅡdiabetes history,large prostate volume,and long operation time are the risk factors for stress urinary incontinence after transurethral thulium laser enucleation of the prostate.The underlying diseases should be actively corrected and controlled before operation,and follow-up and treatment should be strengthened after operation,reduce the rish of this complication and improve the quality of life of patients. |
