腹腔镜前列腺癌根治术后电生理技术早期干预快速控尿临床疗效观察

doi:10.3760/cma.j.cn441417-20250513-13001

国际医药卫生导报 ›› 2025, Vol. 31 ›› Issue (13): 2113-2117.DOI: 10.3760/cma.j.cn441417-20250513-13001

• 泌尿生殖专栏 • 下一篇

腹腔镜前列腺癌根治术后电生理技术早期干预快速控尿临床疗效观察

潘斌¹ 王桂康¹ 徐佳欣¹ 杨志煌² 杨熹² 高坪¹ 陈果¹ 李宇同¹ 周娥³ 陈洁¹

¹暨南大学附属第一医院泌尿外科，广州 510630；²暨南大学附属第五医院泌尿外科，河源 517400；³暨南大学附属第一医院护理部，广州 510630

收稿日期:2025-05-13 出版日期:2025-07-01 发布日期:2025-08-04
通讯作者: 潘斌，Email：panbin@jnu.edu.cn；周娥，Email：zhoue1113@163.com；陈洁，Email：568161322@qq.com
基金资助:
广州市科技计划项目市校联合资助项目（2024A03J1114）；河源市科技计划（河科社农大专项2022018）；暨南大学医学联合基金（YXZY2024012）；广东省医学科研基金（B2025481）

Clinical efficacy observation of early intervention with electrophysiological technology for rapid urinary control after laparoscopic radical prostatectomy

Pan Bin¹, Wang Guikang¹, Xu Jiaxin¹, Yang Zhihuang², Yang Xi², Gao Ping¹, Chen Guo¹, Li Yutong¹, Zhou E³, Chen Jie¹

¹Department of Urology, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China; ²Department of Urology, The Fifth Affiliated Hospital of Jinan University, Heyuan 517400, China; ³Nursing Department, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China

Received:2025-05-13 Online:2025-07-01 Published:2025-08-04
Contact: Pan Bin, Email: panbin@jnu.edu.cn; Zhou E, Email: zhoue1113@163.com; Chen Jie, Email: 568161322@qq.com
Supported by:
Guangzhou Science and Technology Plan Project - Municipal-University Joint Funding (2024A03J1114); Heyuan Science and Technology Plan (Heke She Nong da Zhuanxiang 2022018); Jinan University Medical Joint Fund (YXZY2024012); Guangdong Medical Research Fund (B2025481)

摘要/Abstract

摘要：

　目的　观察腹腔镜前列腺癌根治术联合电生理技术早期干预快速控尿的临床疗效。方法　2021年7月至2025年5月暨南大学附属第一医院泌尿外科31例腹腔镜前列腺癌根治术后第1天采用医用红外线热成像仪（TMT9000）进行可视化电诊断，年龄（69.74±7.12）岁，前列腺特异性抗原（PSA）14.31（8.30，44.19）μg/L，筛选个体化电刺激参数和编制治疗方案，再行经皮低频脉冲神经肌肉电刺激治疗。治疗后对31例患者进行国际尿失禁咨询委员会尿失禁问卷表简表（ICI-Q-SF）、尿失禁生活质量问卷（I-QOL）评分，记录24 h尿垫使用量。结果　所有患者均顺利完成手术，手术时间（5.27±1.03）h，出血50（30，54）ml，盆腔引流管拔除时间（4.96±2.05）d，术后拔除尿管时间（12.70±2.51）d。治疗后ICI-Q-SF评分（4.90±3.46）分，I-QOL评分（94.51±7.86）分。术后拔除尿管，即刻控尿率77.4%（24/31），其中18例（58.1%）拔除尿管后无压力性尿失禁（SUI），无需用尿垫，6例（19.4%）拔尿管当天使用了1片尿垫，但24 h尿垫使用量小于1片；另有7例（22.6%）出现SUI，使用尿垫每天大于1片。随访6个月后，仅1例仍有SUI，使用尿垫每天大于1片。结论　腹腔镜前列腺癌根治术后电生理技术早期干预可快速控尿，安全有效，该项技术有望成为前列腺癌根治术后减少SUI发生的序贯治疗方法。

关键词: , 压力性尿失禁, 经皮低频脉冲神经肌肉电刺激, 早期干预, 前列腺癌

Abstract:

Objective　To evaluate the clinical efficacy of early intervention with electrophysiological technology in achieving rapid urinary control following laparoscopic radical prostatectomy. Methods　From July 2021 to May 2025, 31 patients who underwent laparoscopic radical prostatectomy in the Department of Urology at the First Affiliated Hospital of Jinan University were included. On postoperative day 1, visual electrodiagnosis was performed using a medical infrared thermography device (TMT9000). Their age was (69.74±7.12) years old, and the prostate-specific antigen (PSA) level was 14.31 (8.30, 44.19) μg/L. Individualized electrical stimulation parameters were selected, and a treatment plan was formulated. Subsequently, percutaneous low-frequency pulsed neuromuscular electrical stimulation therapy was administered. Post-treatment outcomes were assessed using the International Consultation on Incontinence Questionnaire-Short Form (ICI-Q-SF) score, the Incontinence Quality of Life Questionnaire (I-QOL) score, and 24-hour pad usage. Results　All patients successfully completed the surgery, with an operative time of (5.27±1.03) hours, a blood loss of 50 (30, 54) ml, a pelvic drainage tube removal time of (4.96±2.05) days, and a catheter removal time of (12.70±2.51) days. After treatment, the ICI-Q-SF score was (4.90±3.46) points, and the I-QOL score was (94.51±7.86) points. Immediate urinary control after catheter removal was achieved in 77.4% (24/31) of the patients: 18 (58.1%) had no stress urinary incontinence (SUI) and required no pads, while 6 (19.4%) used only 1 pad on the day of catheter removal, with 24-hour pad usage less than 1. The remaining 7 patients (22.6%) experienced SUI, using more than 1 pad per day. After 6 months of follow-up, only 1 patient still had SUI, requiring more than 1 pad daily. Conclusion　Early intervention with electrophysiological technology after laparoscopic radical prostatectomy facilitates rapid urinary control and is safe and effective, which may serve as a sequential treatment to reduce the incidence of SUI following radical prostatectomy.

Key words: Stress urinary incontinence, , Percutaneous low-frequency pulsed neuromuscular electrical stimulation, , Early intervention, , Prostate cancer

潘斌王桂康徐佳欣杨志煌杨熹高坪陈果李宇同周娥陈洁.

腹腔镜前列腺癌根治术后电生理技术早期干预快速控尿临床疗效观察 [J]. 国际医药卫生导报, 2025, 31(13): 2113-2117.

Pan Bin, Wang Guikang, Xu Jiaxin, Yang Zhihuang, Yang Xi, Gao Ping, Chen Guo, Li Yutong, Zhou E, Chen Jie.

Clinical efficacy observation of early intervention with electrophysiological technology for rapid urinary control after laparoscopic radical prostatectomy [J]. International Medicine and Health Guidance News, 2025, 31(13): 2113-2117.

参考文献

[1] Siegel RL, Giaquinto AN, Jemal A. Cancer statistics, 2024[J]. CA Cancer J Clin, 2024, 74(1):12-49. DOI: 10.3322/caac.21820.

[2] Han B, Zheng R, Zeng H, et al. Cancer incidence and mortality in China, 2022[J]. J Natl Cancer Cent, 2024, 4(1):47-53. DOI: 10.1016/j.jncc.2024.01.006.

[3] Gacci M, De Nunzio C, Sakalis V, et al. Latest evidence on post-prostatectomy urinary incontinence[J]. J Clin Med, 2023, 12(3):1190. DOI: 10.3390/jcm12031190.

[4] Kominsky HD, Awad MA, Farhi J, et al. Retzius-sparing vs. posterior urethral suspension: similar early-phase post-robotic radical prostatectomy continence outcomes[J]. J Robot Surg, 2024, 18(1):64. DOI: 10.1007/s11701-023-01754-0.

[5] Arroyo C, Martini A, Wang J, et al. Anatomical, surgical and technical factors influencing continence after radical prostatectomy[J]. Ther Adv Urol, 2019, 11:1756287218813787. DOI: 10.1177/1756287218813787.

[6] Azal W Neto, Capibaribe DM, Dal Col LSB, et al. Incontinence after laparoscopic radical prostatectomy: a reverse systematic review[J]. Int Braz J Urol, 2022, 48(3):389-396. DOI: 10.1590/S1677-5538.IBJU.2021.0632.

[7] Huang J, Dai X, Sun J, et al. Prediction models for urinary incontinence after robotic-assisted laparoscopic radical prostatectomy: a systematic review[J]. J Robot Surg, 2024, 18(1):249. DOI: 10.1007/s11701-024-02009-2.

[8] Lardas M, Grivas N, Debray TPA, et al. Patient- and tumour-related prognostic factors for urinary incontinence after radical prostatectomy for nonmetastatic prostate cancer: a systematic review and meta-analysis[J]. Eur Urol Focus, 2022, 8(3):674-689. DOI: 10.1016/j.euf.2021.04.020.

[9] Wagaskar VG, Mittal A, Sobotka S, et al. Hood technique for robotic radical prostatectomy-preserving periurethral anatomical structures in the space of retzius and sparing the pouch of douglas, enabling early return of continence without compromising surgical margin rates[J]. Eur Urol, 2021, 80(2):213-221. DOI: 10.1016/j.eururo.2020.09.044.

[10]魏健文,尹文俊,陈泽楷,等.腹腔镜前列腺癌根治术后电生理技术早期干预恢复控尿功能的临床疗效观察[J].国际医药卫生导报,2022,28(8):1038-1041. DOI:10.3760/cma.j.issn.1007-1245.2022.08.001.

[11] García Cortés Á, Colombás Vives J, Gutiérrez Castañé C, et al. What is the impact of post-radical prostatectomy urinary incontinence on everyday quality of life? Linking Pad usage and International Consultation on Incontinence Questionnaire Short-Form (ICIQ-SF) for a COMBined definition (PICOMB definition)[J]. Neurourol Urodyn, 2021, 40(3):840-847. DOI: 10.1002/nau.24631.

[12] Otmani N, Epstein J, Benaicha N, et al. Cross-cultural adaptation and validation of the Moroccan version of the incontinence quality of life questionnaire (I-QoL) in urinary incontinence patients[J]. J Gynecol Obstet Hum Reprod, 2020, 49(9):101830. DOI: 10.1016/j.jogoh.2020.101830.

[13] Hodges PW, Stafford RE, Hall L, et al. Reconsideration of pelvic floor muscle training to prevent and treat incontinence after radical prostatectomy[J]. Urol Oncol, 2020, 38(5):354-371. DOI: 10.1016/j.urolonc.2019.12.007.

[14] Wang W, Huang QM, Liu FP, et al. Effectiveness of preoperative pelvic floor muscle training for urinary incontinence after radical prostatectomy: a meta-analysis[J]. BMC Urol, 2014, 14:99. DOI: 10.1186/1471-2490-14-99.

[15] 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, 2024, 85(2):139-145. DOI: 10.1016/j.eururo.2023.09.025.

[16] Szopiński T, Sudoł-Szopińska I, Czech AK, et al. Artificial urinary sphincter implantation with periprostatic cuff placement for urinary incontinence in men[J]. Arch Med Sci, 2020, 18(5):1279-1285. DOI: 10.5114/aoms.2019.90803.

[17] Park JJ, Hong Y, Kwon A, et al. Efficacy of surgical treatment for post-prostatectomy urinary incontinence: a systematic review and network meta-analysis[J]. Int J Surg, 2023, 109(3):401-411. DOI: 10.1097/JS9.0000000000000170.

[18] Frazier RL, Jones ME, Hofer MD. Artificial urinary sphincter complications: a narrative review[J]. J Clin Med, 2024, 13(7):1913. DOI: 10.3390/jcm13071913.

[19] Grigoryan B, Kasyan G, Shapovalenko R, et al. Safety and efficacy of artificial urinary sphincter versus male slings in treatment of male urinary incontinence: systematic review and meta-analysis[J]. Continence Reports, 2024,12 100070. DOI:10.1016/j.contre.2024.100070.

[20] Shamout S, Nazha S, Dragomir A, et al. A cost-utility analysis of artificial urinary sphincter versus AdVance male sling in post prostatectomy stress urinary incontinence: a publicly funded health care perspective[J]. Neurourol Urodyn, 2018, 37(7):2195-2203. DOI: 10.1002/nau.23559.

[21] Del Favero L, Tasso G, Deruyver Y, et al. Long-term functional outcomes and patient satisfaction after AdVance and AdVanceXP male sling surgery[J]. Eur Urol Focus, 2022, 8(5):1408-1414. DOI: 10.1016/j.euf.2022.01.017.

[22] Liu J, Zhang J, Yang Z, et al. Comparison of Retzius-sparing and conventional robot-assisted laparoscopic radical prostatectomy regarding continence and sexual function: an updated meta-analysis[J]. Prostate Cancer Prostatic Dis, 2022, 25(1):47-54. DOI: 10.1038/s41391-021-00459-5.

[23]中华医学会男科学分会电生理适宜技术在男科疾病诊疗中的应用中国专家共识编写组.电生理适宜技术在男科疾病诊疗中的应用中国专家共识[J].中华男科学杂志,2022,28(4):366-377. DOI:10.13263/j.cnki.nja.2022.04.013.

[24] Wang D, Shi H, Yang Z, et al. Efficacy and safety of transcutaneous electrical acupoint stimulation for postoperative pain: a meta-analysis of randomized controlled trials[J]. Pain Res Manag, 2022, 2022:7570533. DOI: 10.1155/2022/7570533.

[25]杨玲,姚海军,倪剑书,等.中医经络理论下电生理适宜技术在尿道修复重建患者术后疼痛管理的真实世界应用[J].中华男科学杂志,2023,29(2):174-181. DOI:10.13263/j.cnki.nja.2023.02.011.

腹腔镜前列腺癌根治术后电生理技术早期干预快速控尿临床疗效观察

Clinical efficacy observation of early intervention with electrophysiological technology for rapid urinary control after laparoscopic radical prostatectomy

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