Patient- and Tumour-related Prognostic Factors for Urinary Incontinence After Radical Prostatectomy for Nonmetastatic Prostate Cancer: A Systematic Review and Meta-analysis

被引：35

作者：

Lardas, Michael ^{[1
]}

Grivas, Nikos ^{[2
]}

Debray, Thomas P. A. ^{[3
]}

Zattoni, Fabio ^{[4
]}

Berridge, Christopher ^{[5
]}

Cumberbatch, Marcus ^{[6
]}

Van den Broeck, Thomas ^{[7
]}

Briers, Erik ^{[8
]}

De Santis, Maria ^{[9
,10
]}

Farolfi, Andrea ^{[11
]}

Fossati, Nicola ^{[12
]}

Gandaglia, Giorgio ^{[12
]}

Gillessen, Silke ^{[13
,14
]}

O'Hanlon, Shane ^{[15
]}

Henry, Ann ^{[16
]}

Liew, Matthew ^{[17
]}

Mason, Malcolm ^{[18
]}

Moris, Lisa ^{[7
]}

Oprea-Lager, Daniela ^{[19
]}

Ploussard, Guillaume ^{[20
]}

Rouviere, Olivier ^{[21
]}

Schoots, Ivo G. ^{[22
]}

van der Kwast, Theodorus ^{[23
]}

van der Poel, Henk ^{[24
]}

Wiegel, Thomas ^{[25
]}

Willemse, Peter-Paul ^{[26
]}

Yuan, Cathy Y. ^{[27
]}

Grummet, Jeremy P. ^{[28
]}

Tilki, Derya ^{[29
,30
]}

Bergh, Roderick C. N. van den ^{[31
]}

Lam, Thomas B. ^{[32
]}

Cornford, Philip ^{[33
]}

Mottet, Nicolas

机构：

[1] Metropolitan Gen Hosp, Dept Urol, Athens, Greece

[2] Univ Crete, Univ Gen Hosp Heraklion, Dept Urol, Med Sch, Iraklion, Greece

[3] Univ Utrecht, Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands

[4] St Maria Misericordia Univ Hosp, Urol Unit, Udine, Italy

[5] Worcestershire Acute Hosp NHS Trust, Redditch, Worcestershire, England

[6] Univ Sheffield, Acad Urol Unit, Sheffield, England

[7] Univ Hosp Leuven, Dept Urol, Leuven, Belgium

[8] Patient Advocate, Hasselt, Belgium

[9] Charite Univ Med Berlin, Dept Urol, Berlin, Germany

[10] Med Univ Vienna, Dept Urol, Vienna, Austria

[11] Univ Bologna, Nucl Med, IRCCS Azienda Ospedaliero Univ Bologna, Bologna, Italy

[12] IRCCS Osped San Raffaele, Urol Res Inst, Div Oncol, Unit Urol, Milan, Italy

[13] Oncol Inst Southern Switzerland, Bellinzona, Switzerland

[14] Univ Svizzera Italiana, Lugano, Switzerland

[15] St Vincents Univ Hosp, Med Older People, Dublin, Ireland

[16] Univ Leeds, St Jamess Univ Hosp, Leeds Canc Ctr, Leeds, England

[17] Wigan & Leigh Teaching Hosp NHS Fdn Trust, Dept Urol, Wrightington, Wigan, England

[18] Cardiff Univ, Velindre Canc Ctr, Div Canc & Genet, Sch Med, Cardiff, Wales

[19] Amsterdam Univ Med Ctr, VU Univ, Dept Radiol & Nucl Med, Amsterdam, Netherlands

[20] La Croix Sud Hosp, Quint Fonsegr, Paris, France

[21] Hop Edouard Herriot, Dept Urinary & Vasc Imaging, Hosp Civils Lyon, Lyon, France

[22] Erasmus MC Univ Med Ctr, Dept Radiol & Nucl Med, Rotterdam, Netherlands

[23] Erasmus MC Univ Med Ctr, Dept Pathol, Rotterdam, Netherlands

[24] Netherlands Canc Inst, Dept Urol, Amsterdam, Netherlands

[25] Univ Hosp Ulm, Dept Radiat Oncol, Ulm, Germany

[26] Univ Med Ctr, Utrecht Canc Ctr, Dept Oncol Urol, Utrecht, Netherlands

[27] McMaster Univ, Hlth Sci Ctr, Dept Med, Hamilton, ON, Canada

[28] Monash Univ, Cent Clin Sch, Dept Surg, Melbourne, Australia

[29] Univ Hosp Hamburg Eppendorf, Dept Urol, Hamburg, Germany

[30] Univ Hosp Hamburg Eppendorf, Dept Urol, Hamburg, Germany

[31] Antonius Hosp, Dept Urol, Utrecht, Netherlands

[32] Aberdeen Royal Infirm, Dept Urol, Aberdeen, Aberdeenshire, Scotland

[33] Royal Liverpool & Broadgreen Hosp NHS Trust, Liverpool, Lancashire, England

来源：

EUROPEAN UROLOGY FOCUS | 2022年 / 8卷 / 03期

基金：

英国医学研究理事会;

关键词：

Systematic review; Evidence synthesis; Prostate cancer; Urinary incontinence; Prognostic factors; Patient-related factors; Tumour-related factors; MEMBRANOUS URETHRAL LENGTH; BLADDER NECK PRESERVATION; PREOPERATIVE ERECTILE FUNCTION; NERVE-SPARING PROCEDURE; CONTINENCE RECOVERY; RETROPUBIC PROSTATECTOMY; INDEPENDENT PREDICTOR; IMMEDIATE CONTINENCE; FUNCTIONAL OUTCOMES; CATHETER REMOVAL;

D O I：

10.1016/j.euf.2021.04.020

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Context: While urinary incontinence (UI) commonly occurs after radical prostatectomy (RP), it is unclear what factors increase the risk of UI development.Objective: To perform a systematic review of patient-and tumour-related prognostic factors for post-RP UI. The primary outcome was UI within 3 mo after RP. Secondary outcomes included UI at 3-12 mo and >12 mo after RP.Evidence acquisition: Databases including Medline, EMBASE, and CENTRAL were searched between January 1990 and May 2020. All studies reporting patient-and tumour-related prognostic factors in univariable or multivariable analyses were included. Surgical factors were excluded. Risk of bias (RoB) and confounding assess-ments were performed using the Quality In Prognosis Studies (QUIPS) tool. Random -effects meta-analyses were performed for all prognostic factor, where possible. Evidence synthesis: A total of 119 studies (5 randomised controlled trials, 24 prospective, 88 retrospective, and 2 case-control studies) with 131 379 patients were included. RoB was high for study participation and confounding; moderate to high for statistical analysis, study attrition, and prognostic factor measurement; and low for outcome measurements. Significant prognostic factors for postoperative UI within 3 mo after RP were age (odds ratio [OR] per yearly increase 1.04, 95% confidence interval [CI] 1.03- 1.05), membranous urethral length (MUL; OR per 1-mm increase 0.81, 95% CI 0.74-0.88), prostate volume (PV; OR per 1-ml increase 1.005, 95% CI 1.000-1.011), and Charlson comorbidity index (CCI; OR 1.28, 95% CI 1.09-1.50).Conclusions: Increasing age, shorter MUL, greater PV, and higher CCI are independent prognostic factors for UI within 3 mo after RP, with all except CCI remaining prognostic at 3-12 mo. Patient summary: We reviewed the literature to identify patient and disease factors associated with urinary incontinence after surgery for prostate cancer. We found increasing age, larger prostate volume, shorter length of a section of the urethra (membranous urethra), and lower fitness were associated with worse urinary inconti-nence for the first 3 mo after surgery, with all except lower fitness remaining predictive at 3-12 mo. (c) 2021 European Association of Urology. Published by Elsevier B.V. All rights reserved.

引用

页码：674 / 689

页数：16

共 136 条

[91] Transrectal ultrasound navigation during minilaparotomy retropubic radical prostatectomy: Impact on positive margin rates and prediction of earlier return to urinary continence [J].