切换至 "中华医学电子期刊资源库"

中华腔镜泌尿外科杂志(电子版) ›› 2024, Vol. 18 ›› Issue (01) : 1 -5. doi: 10.3877/cma.j.issn.1674-3253.2024.01.001

专家论坛

盆腔肿瘤手术后的"隐藏危机":泌尿功能障碍的防范与处理
程必盛, 黄海()   
  1. 510120 广州,中山大学孙逸仙纪念医院泌尿外科
  • 收稿日期:2023-11-08 出版日期:2024-02-01
  • 通信作者: 黄海
  • 基金资助:
    中国国家重点研发计划(2022YFC3602900,2022YFC3602904); 国家自然科学基金(81974395,82173036); 广东省基础与应用基础研究基金(2019A1515011437); 广东省国际科技合作项目计划(2021A0505030085); 中山大学临床研究5010计划(2019005); 中山临床研究培育计划(201702); 广东省恶性肿瘤表观遗传和基因调控重点实验室(2020B1212060018OF006); 广东省泌尿系统疾病临床研究中心(2020B1111170006); 北京白求恩慈善基金(mnzl202001); 广州市科技重大专项(202206010117); 北京CSCO临床研究基金(Y-tongshu2021/ms-0162)

"Hidden crisis" after pelvic tumor surgery: prevention and treatment of urinary dysfunction

Bisheng Cheng, Hai Huang()   

  • Received:2023-11-08 Published:2024-02-01
  • Corresponding author: Hai Huang
引用本文:

程必盛, 黄海. 盆腔肿瘤手术后的"隐藏危机":泌尿功能障碍的防范与处理[J]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(01): 1-5.

Bisheng Cheng, Hai Huang. "Hidden crisis" after pelvic tumor surgery: prevention and treatment of urinary dysfunction[J]. Chinese Journal of Endourology(Electronic Edition), 2024, 18(01): 1-5.

外科手术作为治疗盆腔肿瘤的主要手段,在不断进步的手术技术和辅助治疗的支持下,显著改善了盆腔肿瘤患者的术后生存。在追求手术治疗效果的同时,患者的生活质量也日益受到重视。盆腔肿瘤手术和辅助治疗可能会造成邻近泌尿系统器官结构或盆腔神经丛的损伤,引发下尿路反复感染和肾功能受损,对患者的生活质量产生严重影响[1,2]。下尿路功能障碍(lower urinary tract dysfunction,LUTD)相关症状源自受相应神经支配的结构及功能的变化[3,4,5]。因此,有必要探讨如何防范盆腔肿瘤手术后的泌尿功能障碍,以期提升在盆腔肿瘤治疗过程中对泌尿功能的保护意识,降低泌尿功能障碍的发生率,促进术后泌尿功能的恢复。

[1]
薛大伟, 沈新伟, 梁敏, 等.非泌尿外科盆腔手术对下尿路功能的影响[J].现代泌尿外科杂志, 2020, 25(4): 356-359.
[2]
泌尿功能障碍预防和康复协作组. 盆腔肿瘤术后泌尿功能障碍专家共识[J].中华泌尿外科杂志, 2023, 44(2): 81-86.
[3]
Donovan JL, Hamdy FC, Lane JA, et al. Patient-reported outcomes after monitoring, surgery, or radiotherapy for prostate cancer[J]. N Engl J Med, 2016, 375(15): 1425-1437.
[4]
Wu W, Su Y, Huang H, et al. Neuroimaging study investigating the supraspinal control of lower urinary tract function in man with orthotopic ileal neobladder[J]. Front Surg, 2021, 8: 751236.
[5]
Sandhu JS, Breyer B, Comiter C, et al. Incontinence after prostate treatment: AUA/SUFU Guideline[J]. J Urol, 2019, 202(2):369-378.
[6]
张旭. 前列腺根治性切除术尿控之关键外科因素解析——从解剖基础到临床应用[J]. 现代泌尿生殖肿瘤杂志, 2022, 14(6): 321-324.
[7]
Kan KM, Tin AL, Stearns GL, et al. De novo urinary storage symptoms are common after radical prostatectomy: incidence, natural history and predictors[J]. J Urol, 2022, 207(3): 601-608.
[8]
Stabholz Y, Sandhu JS. Management of voiding dysfunction associated with pelvic malignancies[J]. Int J Urol, 2021, 28(1): 17-24.
[9]
Kneist W, Ghadimi M, Runkel N, et al. Pelvic intraoperative neuromonitoring prevents dysfunction in patients with rectal cancer: results from a multicenter, randomized, controlled clinical trial of a NEURO monitoring system (NEUROS)[J]. Ann Surg, 2023, 277(4): e737-e744.
[10]
Kwaan MR, Fan Y, Jarosek S, et al. Long-term risk of urinary adverse events in curatively treated patients with rectal cancer: a population-based analysis[J]. Dis Colon Rectum, 2017, 60(7): 682-690.
[11]
Lange MM, van de Velde CJ. Urinary and sexual dysfunction after rectal cancer treatment[J]. Nat Rev urol, 2011, 8(1): 51-57.
[12]
Wu J, Ye T, Lv J, et al. Laparoscopic nerve-sparing radical hysterectomy vs laparoscopic radical hysterectomy in cervical cancer: a systematic review and meta-analysis of clinical efficacy and bladder dysfunction[J]. J Minim Invasive Gynecol, 2019, 26(3): 417-426.
[13]
杜岳峰, 介评. EU:中国成年女性下尿路症状的患病率、潜在危险因素以及下尿路症状对中国成年女性生活质量的影响[J]. 现代泌尿外科杂志, 2015, 20(8): 596.
[14
Huang L, Guo W, Yang R, et al. Proposed scoring system for evaluating neurologic deficit after sacral resection: functional outcomes of 170 consecutive patients[J]. Spine (Phila Pa 1976) 2016, 41(7): 628-637.
[15]
Zwaans B, Lamb LE, Bartolone S, et al.Cancer survivorship issues with radiation and hemorrhagic cystitis in gynecological malignancies[J]. Int Urol Nephrol, 2018, 50(10): 1745-1751.
[16]
Barry M, Fowler J. Commentary re: effect of radical prostatectomy for prostate cancer on patient quality of life: results from a medicare survey[J]. Urology, 2020, 145: 335-336.
[17]
Cheung F, Sandhu JS. Voiding dysfunction after non-urologic pelvic surgery[J]. Curr Urol Rep 2018, 19(9): 75.
[18]
刘力搏, 李黎娜, 许盛飞, 等. 女性逼尿肌活动低下患者自由尿流率曲线形态分析及其临床意义[J].中华泌尿外科杂志, 2022, 43(1): 56-61.
[19]
Panicker JN. Neurogenic bladder: epidemiology, diagnosis, and management[J]. Semin Neurol 2020, 40(5): 569-579.
[20]
Fan X, Ma X, Lai Y, et al. Suprapubic transvesical repair of vesicovaginal fistula using a homemade laparoscopic single-port device: experience of 42 patients[J]. Front Surg, 2021, 8: 744226.
[21]
Bosch JL, Norton P, Jones JS. Should we screen for and treat lower urinary tract dysfunction after major pelvic surgery? ICI-RS 2011[J]. Neurourol Urodyn, 2012, 31(3): 327-329.
[22]
Xu Y, Liu A, Chen L, et al. Enhanced recovery after surgery (ERAS) pathway optimizes outcomes and costs for minimally invasive radical prostatectomy[J]. J Int Med Res 2020, 48(6): 1220719624.
[23]
Li Z, Li K, Wu W, et al. The comparison of transurethral versus suprapubic catheter after robot-assisted radical prostatectomy: a systematic review and meta-analysis[J]. Transl Androl Urol 2019, 8(5): 476-488.
[24]
Funada S, Yoshioka T, Luo Y, et al.Bladder training for treating overactive bladder in adults[J]. Cochrane Database Syst Rev, 2023, 10(10): D13571.
[25]
Hwang JC, Sun FJ, Su TH, et al. Efficacy of biofeedback and electrostimulation-assisted pelvic floor muscle training between women with mild and moderate to severe stress urinary incontinence[J]. J Clin Med 2022, 11(21):6424.
[26]
Buyukyilmaz F, Culha Y, Zumreler H, et al.The effects of bladder training on bladder functions after transurethral resection of prostate[J]. J Clin Nurs, 2020, 29(11-12): 1913-1919.
[27]
Lambert E, Chartier-Kastler E, Vaessen C, et al. Robot-assisted periprostatic artificial urinary sphincter implantation in men with neurogenic stress urinary incontinence: description of the surgical technique and comparison of long-term functional outcomes with the open approach[J]. Eur Urol 2023, S0302-2838(23)03156-1.
[28]
Baunacke M, Schmidt ML, Groeben C, et al.Treatment of post-prostatectomy urinary incontinence and erectile dysfunction: there is insufficient utilisation of care in German cancer survivors[J]. World J Urol 2021, 39(8): 2929-2936.
[29]
Stoniute A, Madhuvrata P, Still M, et al. Oral anticholinergic drugs versus placebo or no treatment for managing overactive bladder syndrome in adults[J]. Cochrane Database Syst Rev. 2023, 5(5): CD003781.
[30]
Yamada S, Ito Y, Nishijima S, et al. Basic and clinical aspects of antimuscarinic agents used to treat overactive bladder[J]. Pharmacol Ther, 2018, 189: 130-148.
[31]
Deeks ED. Mirabegron: a review in overactive bladder syndrome[J]. Drugs, 2018, 78(8): 833-844.
[1] 刘建龙, 张子轩, 徐圣杰, 张蕴鑫. 颈动脉爆裂综合征发生机制与治疗的研究进展[J]. 中华损伤与修复杂志(电子版), 2023, 18(05): 434-437.
[2] 陈滔, 罗洪, 周进军. 老年食管癌单纯放疗及同期放化疗患者急性不良反应影响因素分析[J]. 中华普外科手术学杂志(电子版), 2023, 17(04): 405-407.
[3] 李腾成, 狄金明. 2023 V1版前列腺癌NCCN指南更新要点解读[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(04): 313-318.
[4] 王昆, 潘迪, 王庆, 江克华, 孙发. 机器人手术治疗膀胱副神经节瘤一例报告[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(03): 291-292.
[5] 南方护骨联盟前列腺癌骨转移专家组. 前列腺癌骨转移诊疗专家共识(2023版)[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(03): 201-208.
[6] 矫珺, 程萌, 矫春峰. 改良呼吸康复训练对肺癌肺叶切除术后呼吸功能和生活质量的影响[J]. 中华肺部疾病杂志(电子版), 2023, 16(05): 709-711.
[7] 罗静, 王霞, 高上兰, 张彬霞, 廖菲. 5A+5R式管理干预在慢性阻塞性肺疾病患者肺康复中的应用[J]. 中华肺部疾病杂志(电子版), 2023, 16(03): 429-431.
[8] 中国医师协会结直肠肿瘤专业委员会, 中国抗癌协会大肠癌专业委员会, 北京整合医学学会结直肠肿瘤分会. 吲哚菁绿近红外荧光血管成像技术应用于腹腔镜结直肠手术中吻合口血供判断中国专家共识(2023版)[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 441-447.
[9] 马慧颖, 凡新苓, 覃仕瑞, 陈佳赟, 曹莹, 徐源, 金晶, 唐源. 磁共振加速器治疗局部晚期直肠癌的初步经验[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 519-523.
[10] 张剑明, 叶文慧, 牟廷裕, 蓝孝亮, 邓海军. 腹腔镜全结直肠切除、回肠J型储袋-肛管吻合术近期并发症及防治策略[J]. 中华结直肠疾病电子杂志, 2023, 12(05): 388-395.
[11] 赵俊华, 杨政伟, 刘阳, 郑银福, 刘建. 规范的术后康复训练对PELD术预后的影响[J]. 中华老年骨科与康复电子杂志, 2023, 09(03): 157-165.
[12] 廖家权, 吴波, 唐昌敏. 体外冲击波联合肌电生物反馈对脑卒中后足下垂的影响[J]. 中华脑科疾病与康复杂志(电子版), 2023, 13(05): 286-292.
[13] 郭翃江, 符雪彩, 朱妍妍, 严之红, 王丽娜, 纪红. 基于影响因素的老年阿尔茨海默病认知功能障碍预测模型构建及电子化认知康复训练的应用价值[J]. 中华脑科疾病与康复杂志(电子版), 2023, 13(03): 156-161.
[14] 梁雪琴, 李娜, 潘芳芳, 张香玉, 段亚男. tDCS结合肌电生物反馈对脑梗死后偏瘫老年患者肢体功能、运动功能和动态姿势稳定性的影响[J]. 中华脑科疾病与康复杂志(电子版), 2023, 13(02): 90-96.
[15] 冉启玉, 汤怀鹏, 孔蕾, 孙冰. 糖尿病视网膜病变中神经退行性变的发病机制及其潜在的治疗方法[J]. 中华诊断学电子杂志, 2023, 11(02): 120-124.
阅读次数
全文


摘要