良性前列腺增生患者经尿道前列腺切除术后膀胱颈挛缩的风险因素。

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

Urologia Internationalis Pub Date : 2024-01-01 Epub Date: 2024-05-13 DOI:10.1159/000539296

Shu-Han Chuang, Chew-Teng Kor, Po-Hung Tseng, Chin-Pao Chang, Hung-Jen Shih, Yueh Pan, Sheng-Hsien Huang

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引用次数: 0

摘要

简介：目的探讨双极 TURP 术后发生 BNC 的相关风险因素。方法该回顾性队列研究纳入了 2010 年至 2021 年期间在我院接受 TURP 的无症状 BPE 患者。采用单变量和多变量 Cox 回归分析评估患者和手术相关因素与 BNC 的关系。通过将患者分为以下四组，对术前导尿和切除速度与 BNC 的关系进行了评估：(1)有或(2)无术前导尿；(3)切除速度高或(4)低。采用 Kaplan-Meier 分析和对数秩检验比较四组患者发生 BNC3Y 的风险。结果 2010年至2021年间，2041名患者接受了TURP手术。术后3年内，306名（15%）患者被诊断为BNC。慢性阻塞性肺病、充血性心力衰竭、术前尿导管检查和低切除速度与较高的 BNC3Y 风险相关。Kaplan-Meier 分析和对数秩检验表明，无论切除速度如何，术前导尿都会增加 BNC 的风险。多变量分析显示，慢性阻塞性肺病和术前导尿是 BNC 的独立预测因素。结论我们的研究结果表明，术前导尿和慢性阻塞性肺病与接受双极 TURP 的 BPE 患者发生 BNC 的风险增加有关。

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Risk Factors for Bladder Neck Contracture following Transurethral Resection of the Prostate in Patients with Benign Prostatic Enlargement.

Introduction: Benign prostatic enlargement (BPE) and lower urinary tract symptoms present challenges in aging men, often addressed through transurethral resection of the prostate (TURP). Despite technological advancements, bladder neck contracture (BNC) remains a concern. This study explores predictors, including comorbidities, influencing BNC after TURP.

Methods: A retrospective cohort study at Changhua Christian Hospital analyzed 2041 BPE patients undergoing bipolar TURP. Preoperative urinary catheterization and resection speed were categorized. Patient data included demographics, comorbidities, operative details, and outcomes. Statistical analyses utilized χ2, Kruskal-Wallis tests, and Cox regression models.

Results: Within 3 years, 306 (15%) patients developed BNC. Univariate Cox regression identified chronic heart failure (p = 0.033), chronic obstructive pulmonary disease (COPD; p = 0.002), preoperative urinary catheterization (p < 0.001), and low resection speed (p = 0.045) as significant BNC risk factors. Notably, COPD (p = 0.011) and preoperative urinary catheterization (p < 0.001) emerged as independent risk factors for BNC development in multivariate Cox regression analysis.

Conclusions: Preoperative urinary catheterization and COPD were significant predictors of BNC post-TURP, while resection speed showed no significant influence. These findings offer clinicians insights for risk assessment, enhancing patient outcomes, and optimizing resources post-TURP.

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来源期刊

Urologia Internationalis 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

6.20%

发文量

审稿时长

3-8 weeks

期刊介绍： Concise but fully substantiated international reports of clinically oriented research into science and current management of urogenital disorders form the nucleus of original as well as basic research papers. These are supplemented by up-to-date reviews by international experts on the state-of-the-art of key topics of clinical urological practice. Essential topics receiving regular coverage include the introduction of new techniques and instrumentation as well as the evaluation of new functional tests and diagnostic methods. Special attention is given to advances in surgical techniques and clinical oncology. The regular publication of selected case reports represents the great variation in urological disease and illustrates treatment solutions in singular cases.