Impact of bladder neck angle measured by postoperative magnetic resonance imaging on mid-term recovery of urinary continence in prostate cancer patients undergoing robot-assisted radical prostatectomy

• Material Type: 博士論文
• Title: Impact of bladder neck angle measured by postoperative magnetic resonance imaging on mid-term recovery of urinary continence in prostate cancer patients undergoing robot-assisted radical prostatectomy
• Author/Editor: 伊藤, 寿樹
• Author Heading: 伊藤, 寿樹
• Publication, Distribution, etc.: Mary Ann Liebert
• Publication Date: 2021-11-19
• Publication Date (W3CDTF): 2021-11-19
• Alternative Title: ロボット支援根治的前立腺全摘除術を施行された前立腺癌患者において術後磁気共鳴画像法で計測される膀胱頸部角が中期尿禁制回復に与える影響; bladder neck angle and incontinece after RARP
• Degree grantor/type: 浜松医科大学
• Date Granted: 2021-12-17
• Date Granted (W3CDTF): 2021-12-17
• Dissertation Number: 乙第584号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: Prostate cancer; Robot-assisted radical prostatectomy; Urinary continence; Magnetic resonance imaging
• Target Audience: 一般
• Note (General): doctoral; 医学系研究科; Introduction: Magnetic resonance imaging (MRI) has helped clarify the relationship between pelvic anatomical structures and functional outcomes after robot-assisted radical prostatectomy (RARP). The objective of this study was to assess the impact of the bladder neck angle (BNA) measured by postoperative MRI on mid-term recovery of urinary continence (UC) in patients undergoing RARP.Methods: This study retrospectively included 200 consecutive patients with prostate cancer who were treated by RARP and received MRI 3 months after RARP. Based on postoperative MRI, the BNA was measured as the angle between the anterior and posterior bladder walls. The mid-term recovery of UC was defined as the use of either no pad or an occasional security pad at 6 months after RARP.Results: 144 of the 200 patients (72.0%) achieved mid-term recovery of UC and the median BNA was 70°. There were no significant differences in several parameters, including age, body mass index, total prostate volume, preservation of the neurovascular bundle, and postoperative membranous urethral length (MUL), between patients with BNA ≥70° and <70°. Of these parameters, only the BNA and postoperative MUL were independently associated with the mid-term recovery of UC. The optimal cutoff points of the BNA and MUL (65° and 9 mm, respectively) were calculated by the receiver operating characteristics curve, and a scoring model for the prediction of mid-term recovery of UC was developed according to the logistic regression analysis. This scoring model was demonstrated to be satisfactorily calibrated (p for Hosmer-Lemeshow test=0.49) and provide good discrimination (area under the curve: 0.723; p<0.001).Conclusions: These findings suggest that mid-term recovery of UC after RARP is favorably affected by the large BNA and long postoperative MUL, and our scoring model can be used as a reliable tool for predicting the midterm continence status after RARP.
• Persistent ID (NDL): info:ndljp/pid/12651290; https://dl.ndl.go.jp/pid/12651290
• Collection: 障害者向け資料
• Collection (Materials For Handicapped People:1): テキストデータ
• Collection (particular): 国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文; https://dl.ndl.go.jp/collections/A00014
• Acquisition Basis: 博士論文（自動収集）
• Date Accepted (W3CDTF): 2023-03-02T11:18:10+09:00
• Format (IMT): application/pdf
• Access Restrictions: 国立国会図書館内限定公開
• Service for the Digitized Contents Transmission Service: 図書館・個人送信対象外
• Availability of remote photoduplication service: 可
• Periodical Title (URI): http://hdl.handle.net/10271/00004208; https://hama-med.repo.nii.ac.jp/records/4086
• Data Provider (Database): 国立国会図書館 : 国立国会図書館デジタルコレクション; https://dl.ndl.go.jp

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