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首页> 外文期刊>The journal of sexual medicine >The Relationship Between Incontinence and Erectile Dysfunction After Robotic Prostatectomy: Are They Mutually Exclusive?
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The Relationship Between Incontinence and Erectile Dysfunction After Robotic Prostatectomy: Are They Mutually Exclusive?

机译：机器人前列腺切除术后失禁与勃起功能障碍的关系：它们是互斥的吗？

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Abstract Background Urinary incontinence (UI) and erectile dysfunction (ED) remain the most common long-term complications of prostatectomy, with a significant impact on sexual health and quality of life. Aims To determine the relation between UI and moderate to severe ED and the risk factors for UI in patients undergoing robotic-assisted laparoscopic prostatectomy. Methods Patients in our institutional database who underwent robotic-assisted laparoscopic prostatectomy for prostate cancer (2006–2013) and who completed the University of California–Los Angeles Prostate Cancer Index and the Sexual Health Inventory for Men (SHIM) surveys at 12 months after prostatectomy were eligible for inclusion. Men who reported use of no urinary pads per day were considered continent, whereas men who used at least one pad per day were considered incontinent. Men with moderate to severe ED based on a SHIM score no higher than 11 were considered to have ED. Patients who had preoperative moderate to severe ED and/or UI based on these definitions were excluded from further analysis. Outcomes A better understanding of what increases the risk for UI after a prostatectomy and how it can co-occur with ED. Results We analyzed 464 patients who met the inclusion criteria. After prostatectomy, 36% of patients had UI and 47% of patients had moderate to severe ED. Of all patients with ED, 45% (98 of 216) were incontinent compared with 27% (67 of 248) of patients without ED ( P P ?= .002) and ED (OR?= 1.88, P ?= .005) were independent predictors for?incontinence. The use of unilateral nerve sparing (OR?= 1.03, P ?= .94) or no nerve sparing (OR?= 0.53, P ?=?.50) during surgery did not have an impact on postoperative incontinence. Clinical Implications Understanding that ED is an independent predictor of UI after robotic-assisted laparoscopic prostatectomy has important clinical implications and suggests a common anatomic pathway. Strengths and Limitations Our focus on different measurements of incontinence and their relation to ED and our use of validated questionnaires to define incontinence and ED were important strengths of this study. Limitations of our study include its retrospective nature and the fact that our results were drawn from a single-center database of a tertiary referral hospital. Conclusion Our results show that the presence of moderate to severe ED after prostatectomy is an independent risk factor for incontinence, suggesting a possible common pathway for these two complications. Further studies to investigate the anatomic and clinical bases of this relation are warranted. Tsikis ST, Nottingham CU, Faris SF. The Relationship Between Incontinence and Erectile Dysfunction After Robotic Prostatectomy: Are They Mutually Exclusive? J Sex Med 2017;14:1241–1247.
机译：摘要背景尿失禁（UI）和勃起功能障碍（ED）仍然是前列腺切除术的最常见的长期并发症，对性健康和生活质量产生重大影响。旨在确定UI与中等至严重ED的关系以及接受机器人辅助腹腔镜前列腺切除术的UI的危险因素。方法方法在我们的机构辅助腹腔镜前列腺切除术治疗前列腺癌（2006-2013）的患者患者（2006-2013），并在前列腺切除术后12个月内完成了加州 - 洛杉矶前列腺癌指数和男性的性健康清单（SHIM）调查有资格包含。报告使用每天没有尿布的人被认为是大陆，而每天至少使用一张垫的人被视为失禁。基于垫片得分的中度至严重埃德的男性被认为没有高于11。从进一步的分析中排除了基于这些定义的术前中度至严重ED和/或UI的患者。结果更好地了解在前列腺切除术后提高UI的风险以及它如何与ED一起发生。结果我们分析了464名符合纳入标准的患者。前列腺切除术后，36％的患者患有UI和47％的患者中度至严重的ed。在所有患有ED的患者中，45％（216个）与27％（67个中的248个）的患者（PP？= .002）和ED（或？= 1.88，P？= .005）相比独立预测因子？尿失禁。使用单侧神经备件（或？= 1.03，p？= .94）或手术期间没有神经备件（或？= 0.53，p？=β.50）对术后尿失禁没有影响。临床意义理解，在机器人辅助的腹腔镜前列腺切除术后，ED是UI的独立预测因子，其具有重要的临床意义，并提示常见的解剖途径。优势和局限我们专注于不同的尿失禁测量及其与ED的关系以及我们使用经过验证的问卷来定义尿失禁和ED是本研究的重要优势。我们的研究的局限性包括其回顾性质，以及我们的结果来自第三节推荐医院的单中心数据库。结论我们的研究结果表明，前列腺切除术后中度至严重的eD是失禁的独立危险因素，表明这两个并发症的可能常见途径。有必要进一步研究来调查这一关系的解剖学和临床基础。 Tsikis st，诺丁汉铜，Faris SF。机器人前列腺切除术后失禁与勃起功能障碍的关系：它们是互斥的吗？ J SEX MED 2017; 14：1241-1247。

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