医学
淋巴囊肿
吻合
前列腺切除术
尿道狭窄
泌尿科
前列腺癌
尿失禁
根治性耻骨后前列腺切除术
外科
国际前列腺症状评分
尿道
前列腺
癌症
内科学
并发症
下尿路症状
作者
Vladimir Vorobev,В. А. Белобородов,В С Лучкевич,Dmitriy Shmakov,О. В. Бакланова,Stepan Sidorov,Bator Sharakshinov
标识
DOI:10.3889/oamjms.2021.7158
摘要
Introduction: The standard treatment for prostate cancer is radical prostatectomy (RP). This surgical technique results in typical complications such as intraoperative blood loss, urethral strictures (vesicourethral anastomosis), urinary incontinence, erectile dysfunction, lymphocele, and the ureter or rectum injury. The study aims to analyze the development of complications after radical prostatectomy.
Materials and methods: The article presents a retrospective analysis of clinical cases with an established diagnosis of prostate cancer from 2012 to 2018 in Irkutsk, Russian Federation. During this period, 52 patients met the study criteria. A multivariate analysis established Non-Nerve-sparing RRP (OR-0.9; 95% CI-1.9; -0.07; p=0.035) as a significant incontinence predictor after 2 years.
Results: Multivariate analysis also established previous transurethral operations as a significant predictor of the vesicourethral anastomosis stricture (OR 6.09; 95% CI 0.71; 11.4; p=0.026), which indicates a six times risk of developing a vesicourethral anastomosis stricture if the patient already had one or more transurethral surgery. Obesity (OR 0.12; 95% CI 0.03; 0.21; p = 0.008), diabetes (OR 2.3; 95% CI 0.45; 4.2; p = 0.015) and coagulopathy (OR 3.1; 95% CI 0.5; 5.7; p = 0.019) became independent predictors of lymphocele development.
Conclusions: The study revealed some new information on the possible predictors of such complications as urinary incontinence in the late period, the lymphocele, and stricture of the vesicourethral anastomosis. Some of the results require further study and confirmation.
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