{"title":"机器人辅助根治性前列腺切除术后长期严重尿失禁的预测因素：一项前瞻性研究。","authors":"Ryo Tanji, Nobuhiro Haga, Akari Hiraguri, Takahiro Tsumori, Tomoyuki Kumekawa, Shunsuke Yoshioka, Hiroki Natsuya, Yusuke Kirihana, Yusuke Hakozaki, Yu Endo, Kei Yaginuma, Syunta Makabe, Akihisa Hasegawa, Yuki Harigane, Hitomi Imai, Satoru Meguro, Akifumi Onagi, Ruriko Takinami, Kanako Matsuoka, Seiji Hoshi, Emina Kayama, Tomoyuki Koguchi, Junya Hata, Yuichi Sato, Hidenori Akaihata, Masao Kataoka, Soichiro Ogawa, Yoshiyuki Kojima","doi":"10.5387/fms.24-00031","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To identify predictors of prolonged severe urinary incontinence after robot-assisted radical prostatectomy (RARP), perioperative clinical parameters were investigated.</p><p><strong>Methods: </strong>Participants were 299 patients who underwent RARP at our institute. Prolonged severe urinary incontinence was defined as a 1-h (one-hour) pad test >50 g/h and/or use of >3 pads/day at 12 months after RARP. The cohort was divided into severe and non-severe urinary incontinence groups according to this criterion. Perioperative clinical parameters were compared between groups to identify predictors for prolonged severe urinary incontinence after RARP.</p><p><strong>Results: </strong>Twenty-seven patients (9.0%) were categorized into the severe urinary incontinence group. The remaining 272 patients (91.0%) were categorized into the non-severe urinary incontinence group. Univariate analysis revealed prolonged severe urinary incontinence as significantly associated with older age (P=0.011), high BMI (P=0.001), lymph node dissection (P=0.003), non-preservation of nerves (P=0.039), non-preservation of fascia of the levator ani muscle (P=0.009), and high risk in the D'Amico risk classification (P=0.010). Multivariate analysis revealed prolonged severe urinary incontinence as significantly correlated with high BMI (P=0.009) and high risk in the D'Amico risk classification (P=0.007).</p><p><strong>Conclusions: </strong>High BMI and D'Amico high-risk status are associated with prolonged severe urinary incontinence after RARP.</p>","PeriodicalId":44831,"journal":{"name":"Fukushima Journal of Medical Science","volume":" ","pages":"227-234"},"PeriodicalIF":0.9000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Predictors of prolonged severe urinary incontinence after robot-assisted radical prostatectomy: a prospective study.\",\"authors\":\"Ryo Tanji, Nobuhiro Haga, Akari Hiraguri, Takahiro Tsumori, Tomoyuki Kumekawa, Shunsuke Yoshioka, Hiroki Natsuya, Yusuke Kirihana, Yusuke Hakozaki, Yu Endo, Kei Yaginuma, Syunta Makabe, Akihisa Hasegawa, Yuki Harigane, Hitomi Imai, Satoru Meguro, Akifumi Onagi, Ruriko Takinami, Kanako Matsuoka, Seiji Hoshi, Emina Kayama, Tomoyuki Koguchi, Junya Hata, Yuichi Sato, Hidenori Akaihata, Masao Kataoka, Soichiro Ogawa, Yoshiyuki Kojima\",\"doi\":\"10.5387/fms.24-00031\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To identify predictors of prolonged severe urinary incontinence after robot-assisted radical prostatectomy (RARP), perioperative clinical parameters were investigated.</p><p><strong>Methods: </strong>Participants were 299 patients who underwent RARP at our institute. Prolonged severe urinary incontinence was defined as a 1-h (one-hour) pad test >50 g/h and/or use of >3 pads/day at 12 months after RARP. The cohort was divided into severe and non-severe urinary incontinence groups according to this criterion. Perioperative clinical parameters were compared between groups to identify predictors for prolonged severe urinary incontinence after RARP.</p><p><strong>Results: </strong>Twenty-seven patients (9.0%) were categorized into the severe urinary incontinence group. The remaining 272 patients (91.0%) were categorized into the non-severe urinary incontinence group. Univariate analysis revealed prolonged severe urinary incontinence as significantly associated with older age (P=0.011), high BMI (P=0.001), lymph node dissection (P=0.003), non-preservation of nerves (P=0.039), non-preservation of fascia of the levator ani muscle (P=0.009), and high risk in the D'Amico risk classification (P=0.010). Multivariate analysis revealed prolonged severe urinary incontinence as significantly correlated with high BMI (P=0.009) and high risk in the D'Amico risk classification (P=0.007).</p><p><strong>Conclusions: </strong>High BMI and D'Amico high-risk status are associated with prolonged severe urinary incontinence after RARP.</p>\",\"PeriodicalId\":44831,\"journal\":{\"name\":\"Fukushima Journal of Medical Science\",\"volume\":\" \",\"pages\":\"227-234\"},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Fukushima Journal of Medical Science\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5387/fms.24-00031\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/24 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Fukushima Journal of Medical Science","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5387/fms.24-00031","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/24 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Predictors of prolonged severe urinary incontinence after robot-assisted radical prostatectomy: a prospective study.
Objectives: To identify predictors of prolonged severe urinary incontinence after robot-assisted radical prostatectomy (RARP), perioperative clinical parameters were investigated.
Methods: Participants were 299 patients who underwent RARP at our institute. Prolonged severe urinary incontinence was defined as a 1-h (one-hour) pad test >50 g/h and/or use of >3 pads/day at 12 months after RARP. The cohort was divided into severe and non-severe urinary incontinence groups according to this criterion. Perioperative clinical parameters were compared between groups to identify predictors for prolonged severe urinary incontinence after RARP.
Results: Twenty-seven patients (9.0%) were categorized into the severe urinary incontinence group. The remaining 272 patients (91.0%) were categorized into the non-severe urinary incontinence group. Univariate analysis revealed prolonged severe urinary incontinence as significantly associated with older age (P=0.011), high BMI (P=0.001), lymph node dissection (P=0.003), non-preservation of nerves (P=0.039), non-preservation of fascia of the levator ani muscle (P=0.009), and high risk in the D'Amico risk classification (P=0.010). Multivariate analysis revealed prolonged severe urinary incontinence as significantly correlated with high BMI (P=0.009) and high risk in the D'Amico risk classification (P=0.007).
Conclusions: High BMI and D'Amico high-risk status are associated with prolonged severe urinary incontinence after RARP.
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