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) ›› 2025, Vol. 19 ›› Issue (05) : 658 -662. doi: 10.3877/cma.j.issn.1674-3253.2025.05.018

综述

机器人辅助下前列腺癌根治术后尿控影响因素的研究进展
李玉志1, 叶春伟2, 杨斌2, 杨德林2,()   
  1. 1655099 云南,曲靖市中医医院泌尿外科
    2650101 云南,昆明医科大学第二附属医院泌尿外科
  • 收稿日期:2023-11-03 出版日期:2025-10-01
  • 通信作者: 杨德林

Advances on influencing factors of urinary continence recovery following robot-assisted radical prostatectomy

Yuzhi Li1, Chunwei Ye2, Bin Yang2, Delin Yang2,()   

  1. 1Department of Urology, Qujing Hospital of Traditional Chinese Medicine, Qujing 655099, China
    2Department of Urology, Second Affiliated Hospital of Kunming Medical University, Kunming 650101, China
  • Received:2023-11-03 Published:2025-10-01
  • Corresponding author: Delin Yang
引用本文:

李玉志, 叶春伟, 杨斌, 杨德林. 机器人辅助下前列腺癌根治术后尿控影响因素的研究进展[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(05): 658-662.

Yuzhi Li, Chunwei Ye, Bin Yang, Delin Yang. Advances on influencing factors of urinary continence recovery following robot-assisted radical prostatectomy[J/OL]. Chinese Journal of Endourology(Electronic Edition), 2025, 19(05): 658-662.

前列腺癌发病率逐年升高,现已成为我国最常见的男性恶性肿瘤之一。机器人辅助腹腔镜前列腺癌根治术(RARP)成了越来越多前列腺癌患者的治疗选择,但是术后尿失禁仍然是一个迫切需要解决的难题。研究RARP术后尿控恢复的影响因素,可为临床提供更好的评估与治疗方案。本文对RARP术后尿控恢复的影响因素及研究进展进行综述。

The incidence of prostate cancer has been increasing annually, making it one of the most common male malignant tumors in China. Robot-assisted laparoscopic radical prostatectomy (RARP) has become a treatment option for an increasing number of prostate cancer patients. However, postoperative urinary incontinence remains an urgent challenge requiring resolution. Studying the influencing factors of urinary continence recovery after RARP may provide better clinical assessment and treatment strategies. This article reviews recent research progress on factors affecting urinary continence recovery following RARP.

[1]
Vidmar R, Marcq G, Flamand V, et al. Salvage radical prostatectomy for recurrent prostate cancer. Morbidity, oncological and functional results[J]. Prog Urol, 2017, 27(8-9): 458-466. DOI: 10.1016/j.purol.2017.05.005.
[2]
Zhang AY, Chiam K, Haupt Y, et al. An analysis of a multiple biomarker panel to better predict prostate cancer metastasis after radical prostatectomy[J]. Int J Cancer, 2019, 144(5): 1151-1159. DOI: 10.1002/ijc.31906.
[3]
Salomon L, Saint F, Anastasiadis AG, et al. Combined reporting of cancer control and functional results of radical prostatectomy[J]. Eur Urol, 2003, 44(6): 656-660. DOI: 10.1016/j.eururo.2003.09.009.
[4]
贺全浩, 廖方通, 彭粲杰, 等. 机器人辅助腹腔镜前列腺癌根治术与腹腔镜前列腺癌根治术术后疗效对比分析:倾向性评分匹配队列研究[J]. 重庆医科大学学报, 2023, 48(8): 940-944. DOI: 10.13406/j.cnki.cyxb.003287.
[5]
Porpiglia F, Fiori C, Bertolo R, et al. Five-year outcomes for a prospective randomised controlled trial comparing laparoscopic and robot-assisted radical prostatectomy[J]. Eur Urol Focus, 2018, 4(1): 80-86. DOI: 10.1016/j.euf.2016.11.007.
[6]
Stolzenburg JU, Holze S, Neuhaus P, et al. Robotic-assisted versus laparoscopic surgery: outcomes from the first multicentre, randomised, patient-blinded controlled trial in radical prostatectomy (LAP-01)[J]. Eur Urol, 2021, 79(6): 750-759. DOI: 10.1016/j.eururo.2021.01.030.
[7]
Kitamura K, China T, Kanayama M, et al. Significant association between urethral length measured by magnetic resonance imaging and urinary continence recovery after robot-assisted radical prostatectomy[J]. Prostate Int, 2019, 7(2): 54-59. DOI: 10.1016/j.prnil.2018.06.003.
[8]
Kohjimoto Y, Yamashita S, Kikkawa K, et al. The association of length of the resected membranous urethra with urinary incontinence after radical prostatectomy[J]. Urol J, 2020, 17(2): 146-151. DOI: 10.22037/uj.v0i0.4753.
[9]
Greenberg SA, Cowan JE, Lonergan PE, et al. The effect of preoperative membranous urethral length on likelihood of postoperative urinary incontinence after robot-assisted radical prostatectomy[J]. Prostate Cancer Prostatic Dis, 2022, 25(2): 344-350. DOI: 10.1038/s41391-022-00527-4.
[10]
Tutolo M, Rosiello G, Stabile G, et al. The key role of levator ani thickness for early urinary continence recovery in patients undergoing robot-assisted radical prostatectomy: a multi-institutional study[J]. Neurourol Urodyn, 2022, 41(7): 1563-1572. DOI: 10.1002/nau.25001.
[11]
Nakamura M, Yamada Y, Sato Y, et al. Preservation of pelvic floor muscles contributes to early continence recovery after robot-assisted radical prostatectomy[J]. PLoS One, 2022, 17(10): e0275792. DOI: 10.1371/journal.pone.0275792.
[12]
Hikita K, Honda M, Teraoka S, et al. Intravesical prostatic protrusion may affect early postoperative continence undergoing robot-assisted radical prostatectomy[J]. BMC Urol, 2020, 20(1): 164. DOI: 10.1186/s12894-020-00740-0.
[13]
Jo JK, Hong SK, Byun SS, et al. Urinary continence after robot-assisted laparoscopic radical prostatectomy: the impact of intravesical prostatic protrusion[J]. Yonsei Med J, 2016, 57(5): 1145-1151. DOI: 10.3349/ymj.2016.57.5.1145.
[14]
Lee SE, Byun SS, Lee HJ, et al. Impact of variations in prostatic apex shape on early recovery of urinary continence after radical retropubic prostatectomy[J]. Urology, 2006, 68(1): 137-141. DOI: 10.1016/j.urology.2006.01.021.
[15]
Wenzel M, Preisser F, Mueller M, et al. Effect of prostatic apex shape (Lee types) and urethral sphincter length in preoperative MRI on very early continence rates after radical prostatectomy[J]. Int Urol Nephrol, 2021, 53(7): 1297-1303. DOI: 10.1007/s11255-021-02809-7.
[16]
Iacovelli V, Carilli M, Sandri M, et al. The role of preoperative prostatic shape in the recovery of urinary continence after robotic radical prostatectomy: a single cohort analysis[J]. Prostate Cancer Prostatic Dis, 2022, 26(2): 374-378. DOI: 10.1038/s41391-022-00563-0.
[17]
Mitsui Y, Sadahira T, Watanabe T, et al. Correlation between lumbar skeletal muscle size and urinary incontinence after radical prostatectomy[J]. Low Urin Tract Symptoms, 2020, 12(3): 245-252. DOI: 10.1111/luts.12312.
[18]
Yamashita S, Kawabata H, Deguchi R, et al. Myosteatosis as a novel predictor of urinary incontinence after robot-assisted radical prostatectomy[J]. Int J Urol, 2022, 29(1): 34-40. DOI: 10.1111/iju.14704.
[19]
Galfano A, Ascione A, Grimaldi S, et al. A new anatomic approach for robot-assisted laparoscopic prostatectomy: a feasibility study for completely intrafascial surgery[J]. Eur Urol, 2010, 58(3): 457-461. DOI: 10.1016/j.eururo.2010.06.008.
[20]
Ota Y, Hamamoto S, Matsuyama N, et al. Pelvic anatomical features after retzius-sparing robot-assisted radical prostatectomy intended for early recovery of urinary symptoms[J]. J Endourol, 2021, 35(3): 296-304. DOI: 10.1089/end.2020.0463.
[21]
Kadono Y, Nohara T, Kawaguchi S, et al. Investigating the mechanism underlying urinary continence using dynamic MRI after Retzius-sparing robot-assisted radical prostatectomy[J]. Sci Rep, 2022, 12(1): 3975. DOI: 10.1038/s41598-022-07800-5.
[22]
Salazar A, Regis L, Planas J, et al. A randomised controlled trial to assess the benefit of posterior rhabdosphincter reconstruction in early urinary continence recovery after robot-assisted radical prostatectomy[J]. Eur Urol Oncol, 2022, 5(4): 460-463. DOI: 10.1016/j.euo.2021.02.005.
[23]
Ficarra V, Rossanese M, Crestani A, et al. Robot-assisted radical prostatectomy using the novel urethral fixation technique versus standard vesicourethral anastomosis[J]. Eur Urol, 2021, 79(4): 530-536. DOI: 10.1016/j.eururo.2021.01.028.
[24]
Li X, Zhang H, Jia Z, et al. Urinary continence outcomes of four years of follow-up and predictors of early and late urinary continence in patients undergoing robot-assisted radical prostatectomy[J]. BMC Urol, 2020, 20(1): 29. DOI: 10.1186/s12894-020-00601-w.
[25]
Lee K, Shiota M, Takamatsu D, et al. Correlation between extended pelvic lymph node dissection and urinary incontinence at early phase after robot-assisted radical prostatectomy[J]. Int J Urol, 2023, 30(4): 340-346. DOI: 10.1111/iju.15119.
[26]
Menon M, Shrivastava A, Kaul S, et al. Vattikuti Institute prostatectomy: contemporary technique and analysis of results[J]. Eur Urol, 2007, 51(3): 648-657;discussion 657-658. DOI: 10.1016/j.eururo.2006.10.055.
[27]
Menon M, Shrivastava A, Bhandari M, et al. Vattikuti Institute prostatectomy: technical modifications in 2009[J]. Eur Urol, 2009, 56(1): 89-96. DOI: 10.1016/j.eururo.2009.04.032.
[28]
Hashimoto T, Yoshioka K, Gondo T, et al. The impact of lateral bladder neck preservation on urinary continence recovery after robot-assisted radical prostatectomy[J]. J Endourol, 2018, 32(1): 40-45. DOI: 10.1089/end.2017.0459.
[29]
Sood A, Grauer R, Jeong W, et al. Evaluating post radical prostatectomy mechanisms of early continence[J]. Prostate, 2022, 82(12): 1186-1195. DOI: 10.1002/pros.24371.
[30]
Song QX, Li J, Shen K, et al. The application of "S.I.S" technique improves long-term continence after robotic radical prostatectomy[J]. Neurourol Urodyn, 2023, 42(3): 650-661. DOI: 10.1002/nau.25131.
[31]
Shin TY, Lee YS. Detrusorrhaphy during robot-assisted radical prostatectomy: early recovery of urinary continence and surgical technique[J]. Biomed Res Int, 2019, 2019: 1528142. DOI: 10.1155/2019/1528142.
[32]
Kumar A, Samavedi S, Bates AS, et al. Continence outcomes of robot-assisted radical prostatectomy in patients with adverse urinary continence risk factors[J]. BJU Int, 2015, 116(5): 764-770. DOI: 10.1111/bju.13106.
[33]
Cakmak S, Canda AE, Ener K, et al. Does type 2 diabetes mellitus have an impact on postoperative early, mid-term and late-term urinary continence after robot-assisted radical prostatectomy?[J]. J Endourol, 2019, 33(3): 201-206. DOI: 10.1089/end.2018.0822.
[34]
花卉, 许晨莹, 刘金凤, 等. 盆底肌训练时机对高龄初产妇产后盆底肌张力及性功能的影响[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(3): 284-291. DOI: 10.3877/cma.j.issn.1673-5250.2024.03.007.
[35]
Lucas M, Bedretdinova D, Berghmans L, et al. Guidelines on urinary incontinence[G]. In: EAU Guidelines, 2015 edition. Arnhem (NL): Eur Association Urol, 2015, 23-24.
[36]
Filocamo MT, Marzi VL, Del Popolo G, et al. Pharmacologic treatment in postprostatectomy stress urinary incontinence[J]. Eur Urol, 2007, 51(6): 1559-1564. DOI: 10.1016/j.eururo.2006.08.005.
[37]
郑荣寿, 孙可欣, 张思维, 等. 2015年中国恶性肿瘤流行情况分析[J]. 中华肿瘤杂志, 2019, 41(1): 19-28. DOI: 10.3760/cma.j.issn.0253-3766.2019.01.005.
[1] 向涵, 母德安, 王强, 黄英杰, 张伟. 3D荧光反染超微创单孔腹腔镜Ⅵ段、Ⅴ段背侧段解剖性肝切除[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(06): 610-610.
[2] 燕速, 梁浩, 黄涛. 腹腔镜右半结肠癌扩大切除术[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(06): 609-609.
[3] 杜晓辉, 谢天宇, 晏阳. 我国腹腔镜结直肠癌外科治疗现状、问题与未来[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(06): 600-604.
[4] 张建锋, 田若曦, 李保坤, 马洪庆, 胡旭华, 曹龙飞, 王贵英. 我国腹腔镜右半结肠癌的手术难点及对策[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(06): 605-608.
[5] 陈朝乾, 赵宗贤, 徐顺, 姚远, 孙杰. 腹腔镜Dixon术中保留左结肠动脉对老年低位直肠癌患者的影响[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(06): 611-614.
[6] 严征远, 张恒, 曹能琦, 方兴超, 陈大敏. 单孔+1腹腔镜结直肠癌根治切除术的有效性及安全性临床观察[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(06): 615-618.
[7] 薛兆强, 袁寅. 双镜联合保功能胃癌根治术治疗早期近端胃癌的临床研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(06): 628-632.
[8] 贺子蕗, 张靖, 刘卓, 李昊楠, 赵鑫鑫, 孙泽辉. 改良内翻手工缝合的Overlap吻合法在腹腔镜全胃切除术中的临床研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(06): 633-636.
[9] 周丽君, 李姣姣, 孙燕, 王露, 钱蓉. 不同吻合方式对腹腔镜辅助远端胃癌根治术患者术后恢复的影响[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(06): 642-645.
[10] 熊余送, 许东民, 张伟伟, 汪扬, 陶勇, 朱峰. LCBDE术中胆总管单纯一期缝合的疗效观察[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(06): 654-657.
[11] 王毅, 孔剑桥, 张鹏, 代扬, 李恒平. 腹腔镜超声引导十二指肠镜治疗胆囊合并胆总管结石[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(06): 658-661.
[12] 陈敏, 陈挺, 范杰, 陈霄. PTCSL与LCBDE对肝内胆管结石患者应激反应和结石清除率的影响[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(06): 662-665.
[13] 张超, 常剑. 混合入路与中间入路行腹腔镜右半结肠癌根治术的近中期随访比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(06): 685-688.
[14] 陈思鹭, 杨兴, 李学松, 谌诚. 靶向PSMA的荧光探针在前列腺癌显像中的研究进展[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(05): 547-551.
[15] 潘麒文, 何立儒. 前列腺癌放射治疗前沿进展[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(05): 552-557.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?