Effect of Prostate Volume on the Outcomes of Nerve Sparing Laparoscopic Radical Prostatectomy and its Predictive Value for Postoperative Continence Recovery
- VernacularTitle:前列腺体积对保留神经根治性前列腺切除术的影响及其预测术后控尿恢复价值
- Author:
Dong-gen JIANG
1
;
Xiang-wei YANG
1
;
Jun LI
1
;
Chu-jie CHEN
1
;
Xin GAO
2
;
Jun PANG
3
;
Guo-long LIAO
1
Author Information
1. Department of Urology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, China
2. Department of Urology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China
3. Department of Urology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, China; Department of Urology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China
- Publication Type:Journal Article
- Keywords:
prostate cancer(PCa);
nerve sparing laparoscopic radical prostatectomy(nsLRP);
prostate volume;
treatment outcomes;
urinary incontinence
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2020;41(5):753-757
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】 To explore the effect of prostate volume on outcomes of nerve sparing laparoscopic radical prostatectomy(nsLRP) and investigate its predictive value for postoperative continence recovery. 【Methods】 A retrospective study was conducted on 178 patients with low risk prostate cancer(PCa) who underwent nsLRP from January 2004 to June 2018. All the patients included had normal preoperative urinary function, a mean age of 66 years(range 46~88), a median PSA level of 6.9 μg/L(range 0.6~10.0) and a mean body mass index of(24±5) kg/m2. The correlation of prostate volume with perioperative data was assessed by using Spearman correlation coefficient. Univariate and multivariate Cox regression analyses were employed to identify prognostic predictors for postoperative continence recovery. 【Results】 Increased prostate volume was significantly correlated with older age(rs=0.370, P<0.001), higher PSA level(rs=0.168, P=0.025), lower biopsy Gleason score(rs=-0.165, P=0.027), lower pathological T stage(rs=-0.152, P=0.042) and Gleason score(rs=-0.182, P=0.015), longer operative time(rs=0.239, P=0.001) and greater estimated blood loss(rs= 0.181, P=0.016). The continence rates in the 3rd, 6th, and 12th month after surgery were 64.0%(114/178), 88.2% (157/178), and 96.1%(171/178), respectively. Univariate and multivariate Cox analysis showed that patient age(RR= 0.528, 95% CI: 0.381~0.730) and prostate volume(RR=0.598, 95% CI: 0.412~0.869) were independent predictors of continence recovery. 【Conclusions】 Larger prostate volume was associated with older age, higher PSA level, lower tumor stage and grade, greater intraoperative blood loss and longer operative time in low risk PCa patients. Older age and increased prostate volume may independently predict poor continence recovery after nsLRP.
