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早期与延迟的尿道外科手术在急性尿路滞留:时间是否有所不同?
Daniel M Frendl1,2, Wesley H Chou1, Ya-Wen Chen3
1Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
The Journal of urology
|May 30, 2023
概括
良性前列腺激增症 (BPH) 的早期透尿道手术与更好的结果有关. 在急性尿后推迟手术增加了治疗失败和重新手术的风险.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 外科手术的结果
- 医疗保健服务研究 医疗服务研究
背景情况:
- 良性前列腺增生症 (BPH) 是老年男性常见的疾病.
- 急性尿 (AUR) 是BPH的常见并发症,通常需要导管.
- 在AUR之后进行手术干预的最佳时间仍在争论中.
研究的目的:
- 为了比较BPH进行过尿道外科手术的男性的长期手术结果.
- 评估手术前急性尿 (AUR) 和延迟手术对治疗失败的影响.
- 评估AUR事件的数量是否会影响术后结果.
主要方法:
- 对17474名因BPH而接受过尿道外科手术的男性进行了回顾性队列分析 (2002-2016).
- 根据手术前AUR的缺席或存在 (1或≥2次) 和手术前的时间 (0-6个月或>6个月) 分类的患者.
- 细灰竞争风险模型用于预测10年手术失败 (重新操作或再导管),死亡作为竞争风险.
主要成果:
- 10%的患者经历了手术前的AUR,其中37%的患者面临手术延迟≥6个月.
- 10年治疗失败率为17.2% (没有AUR),34.0% (≥2次AUR发作) 和32.9% (≥6个月延迟).
- 导管后手术延迟显著增加了治疗失败的风险 (SHR为1.49<6个月,SHR为2.11≥6个月).
结论:
- 手术前的急性尿与BPH手术后的长期结果明显差.
- 在AUR的导管治疗后推迟的手术干预导致治疗失败率更高.
- 及时的手术管理对于优化BPH和AUR男性的长期结果至关重要.
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