机器人辅助根治性前列腺切除术中保留盆底稳定结构的中长期尿控效果分析OA

Objective To evaluate the mid-to long-term effects of the pelvic-peritoneal structure-sparing(PPSS)technique,which aims to preserve the stability of pelvic floor structures,on urinary continence recovery after robot-assisted radical prostatectomy(RARP).Methods This single-center retrospective cohort study included 82 patients who underwent RARP between October 2017 and May 2018,all operated on by the same surgeon.Patients were divided into a PPSS group(n=53)and a non-PPSS group(n=29).Standard RARP was performed in the non-PPSS group,whereas the PPSS group involved preservation of pelvic floor structures and cold-knife apical dissection for urethral function protection.Baseline characteristics were comparable between the two groups.Follow-up lasted up to 7 years.Urinary continence was defined as the use of 0-1 pad per day and was assessed at 3,6,12,24 months postoperatively and at the last follow-up(July 2025).Kaplan-Meier analysis and Cox regression were used to compare continence recovery rates and identify influencing factors.Results The median follow-up duration was 1 178 days(range:1-2 743 days).The PPSS group had significantly higher continence recovery rates at 3 and 6 months(71.6%and 75.4%)compared with the non-PPSS group(44.8%and 48.2%;P=0.030 and P=0.025,respectively),while no significant difference was observed at 12 months and thereafter.Multivariate Cox regression analysis showed that the PPSS technique(hazard ratio[HR]=2.59,95%CI:1.39-4.81,P=0.002)and age(HR=0.94,95%CI:0.91-0.97,P=0.001)were independent predictors of continence recovery.Conclusion The PPSS technique improves early postoperative urinary continence without increasing the rate of positive surgical margins.Although it does not significantly enhance long-term continence,it may still contribute positively to patients'postoperative quality of life.