医学
前列腺切除术
组内相关
置信区间
尿失禁
优势比
泌尿科
尿道
前列腺
逻辑回归
内科学
癌症
临床心理学
心理测量学
作者
Markus Sauer,Pierre Tennstedt,Christoph Berliner,Lennart Well,Hartwig Huland,Lars Budäus,Gerhard Adam,Dirk Beyersdorff
标识
DOI:10.1016/j.ejrad.2019.108668
摘要
Purpose To evaluate standardized measurements of the membranous urethra length (MUL), the membranous urethra angle (MUA) and the prostate’s apex type (AT) among further clinical parameters as potential preoperative risk factors of urinary incontinence (UI) after radical prostatectomy (RP). Method Our institutional review board approved this retrospective single center study. 316 patients (mean age 65 years) underwent MRI at 3 T prior to prostatectomy. MUL, MUA and AT were measured according to a standardized approach on T2w- sagittal sequences. In a second reading the inter-rater agreement for the MUL was determined. Image findings and clinical data were correlated by logistic regression to UI as evaluated by a standardized questionnaire determining the number of necessary hygiene pads (HP) at three different time points with corresponding patient subsets (one week, six months and 12 months after RP). Results There was a significant impact of the MUL on postoperative UI with odds ratios (OR) of 0.8 [p < 0.001; confidence interval (CI) 0.73-0.91], 0.8 (p = 0.01; CI 0.68-0.94) and 0.7 (p < 0.01; CI 0.56-0.89) at the respective time points. No significant impact was demonstrated regarding the MUA and AT. Of all clinical parameters there was significant impact of the patients’ age and the degree of nerve-sparing surgery. Inter-rater agreement with respect to the MUL was good with an intraclass correlation coefficient of 0.82. The mean deviation of raters measuring the MUL was 1.2 mm. Conclusions A shorter MUL in mpMRI should be considered as a risk factor of UI after RP. Standardized measurements enabling good inter-rater agreement should be considered for routine assessments to facilitate prospective classifications.
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