Analysis Of Related Factors Affecting Early Urinary Control After Radical Resection Of Local High-risk Prostate Cancer And Establishment Of Prediction Model

Objective: To analyze the preoperative related influencing factors of postoperative urinary incontinence in high-risk local prostate cancer patients,and to establish a predictive urinary incontinence histogram based on the results of multivariate analysis and R language.Therefore,it is helpful to prevent and treat the urinary incontinence after operation.Methods: This study retrospectively analyzed the preoperative clinical data of 97 patients receiving radical prostatectomy in the Department of Urology,Ningxia Medical University General Hospital from January 2013 to January 2023,82 of whom met the eligibility for inclusion.A univariate analysis was performed for preoperative correlation factors that might affect postoperative urinary incontinence,including age,smoking history,alcohol history,hypertension,diabetes,BMI,preoperative PSA,Gleason score,Preoperative endocrine therapy,prostate surgery history,prostate volume,and bladder function.Then SPSS26.0 software was used to analyze the logistic regression of multiple factors,and the factors of P < 0.05 were considered as independent risk factors.Using R4.0.3 software,a line graph prediction model of urine incontinence was created based on the independent risk variables.To test the prediction model,the calibration curve was made using 100 bootstrap resamples,the C index was computed,the ROC curve was formed,the area under the curve was calculated,and the decision curve was founded.Results: One month following surgery,all 82 participants in this trial were successfully followed up.Factors associated with the recovery of urinary control include age > 60,history of electroprostatectomy,neoadjuvant treatment,prostate volume and decompensation of bladder function(P < 0.05).Age>60 years old,history of electroprostatectomy and decompensation of bladder function were independent risk factors for early postoperative urinary control.In this study,an early urine control diagram was established based on independent risk factors.The calibration curve of the model was well fitted,with C index0.757,sensitivity and specificity 79.4% and 70.8%,respectively,and the area under ROC curve 0.775.Conclusions: Age > 60 years old,history of electroprostatectomy and decompensation of bladder function are independent risk factors for postoperative urinary incontinence in high-risk local prostate cancer patients.The model has a good predictive capability for early postoperative urinary control,which can be used to estimate the rate of urinary incontinence,and provide a reference for surgical procedures and postoperative rehabilitation in high-risk local PCa patients.