男性盆底MRI形态学参数对前列腺增生患者术后尿失禁的预测价值OA

Objective:To explore the predictive value of male pelvic floor MRI morphological parameters for postoperative uri-nary incontinence in patients with benign prostatic hyperplasia(BPH).Methods:Clinical and follow-up data of 104 patients with BPH who underwent transurethral electro vaporization of the prostate(TUERP)at Hainan General Hospital between January 2021 and June 2023 were collected.Based on the occurrence of urinary incontinence one month after surgery,patients were divided into a urinary control group(n=76)and an incontinence group(n=28).Comparative analyses of demographic data and preopera-tive pelvic MRI morphological parameters-including prostate volume(PV),intravesical prostatic protrusion(IPP),prostatic ure-thral angle(PUA),bladder neck diameter(BND),bladder neck thickness(BNT),membranous urethral length(MUL),and membranous urethral thickness(MUT)were performed.Logistic regression was used to identify independent predictors of postop-erative urinary incontinence in BPH patients.The diagnostic performance of individual parameters was assessed using receiver op-erating characteristic(ROC)curves and area under the curve(AUC)analysis.A nomogram model predicting the risk of postoper-ative urinary incontinence was developed using R software(version 4.3.0),and the model's performance was evaluated.Results:Patients in the urinary incontinence group were older and had longer surgery durations compared to the urinary control group,with greater prostate volume(PV),intravesical prostatic protrusion(IPP),and prostatic urethral angle(PUA),while membranous urethral length(MUL)and thickness(MUT)were lower(P<0.05).Multivariate logistic regression identified PV,PUA,and diabetes as independent risk factors for postoperative urinary incontinence in BPH patients(P<0.05),with MUL serving as an in-dependent protective factor(P<0.05).The areas under the curve for PV,PUA,MUL,and diabetes were 0.828,0.856,0.875,and 0.610,respectively.Incorporating these factors into a nomogram model yielded an overall predictive accuracy of 96.10%.Con-clusion:Preoperative PV,PUA,MUL and the presence of diabetes are independent predictors of postoperative urinary inconti-nence in patients with BPH.The nomogram constructed from these variables provides an effective tool for assessing the risk of uri-nary incontinence following TUERP.