腹腔鏡下前立腺摘除術の下部尿路症状に与える影響
【目的】腹腔鏡下前立腺摘除術（LRP）の下部尿路症状（LUTS）に与える影響を明らかにするため，術前LUTSの有無と排尿QOLの変化について検討した． 【対象および方法】LRPを施行した196例に対し，術前後に排尿関連QOL調査（IPSS，QOLスコア，UCLA-PCI）を行った． 術前IPSSによりLUTS群， 非LUTS群に分けて，術後排尿QOLの変化を検討した． 【結果】LUTS群は非LUTS群に比べ術後排尿QOLの早い回復を認めた．IPSSおよびQOLスコアは，LUTS群では術前に比べ有意な改善を認めた．術前IPSSは術後QOLスコア回復の有意な予測因子であった． 【結論】LUT...
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| Published in | Japanese Journal of Endourology Vol. 28; no. 2; pp. 263 - 269 |
|---|---|
| Main Authors | , , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本泌尿器内視鏡学会
01.09.2015
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| Subjects | |
| Online Access | Get full text |
| ISSN | 2186-1889 2187-4700 |
| DOI | 10.11302/jsejje.28.263 |
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| Abstract | 【目的】腹腔鏡下前立腺摘除術（LRP）の下部尿路症状（LUTS）に与える影響を明らかにするため，術前LUTSの有無と排尿QOLの変化について検討した． 【対象および方法】LRPを施行した196例に対し，術前後に排尿関連QOL調査（IPSS，QOLスコア，UCLA-PCI）を行った． 術前IPSSによりLUTS群， 非LUTS群に分けて，術後排尿QOLの変化を検討した． 【結果】LUTS群は非LUTS群に比べ術後排尿QOLの早い回復を認めた．IPSSおよびQOLスコアは，LUTS群では術前に比べ有意な改善を認めた．術前IPSSは術後QOLスコア回復の有意な予測因子であった． 【結論】LUTS患者は非LUTS患者に比べ，LRPにより術後排尿QOLが早く回復し，排尿症状は術前より改善することが示唆された． |
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| AbstractList | 「要旨」【目的】腹腔鏡下前立腺摘除術(LRP)の下部尿路症状(LUTS)に与える影響を明らかにするため, 術前LUTSの有無と排尿QOLの変化について検討した. 【対象および方法】LRPを施行した196例に対し, 術前後に排尿関連QOL調査(IPSS, QOLスコア, UCLA-PCI)を行った, 術前IPSSによりLUTS群, 非LUTS群に分けて, 術後排尿QOLの変化を検討した. 【結果】LUTS群は非LUTS群に比べ術後排尿QOLの早い回復を認めた. IPSSおよびQOLスコアは, LUTS群では術前に比べ有意な改善を認めた. 術前IPSSは術後QOLスコア回復の有意な予測因子であった. 【結論】LUTS患者は非LUTS患者に比べ, LRPにより術後排尿QOLが早く回復し, 排尿症状は術前より改善することが示唆された. 【目的】腹腔鏡下前立腺摘除術（LRP）の下部尿路症状（LUTS）に与える影響を明らかにするため，術前LUTSの有無と排尿QOLの変化について検討した． 【対象および方法】LRPを施行した196例に対し，術前後に排尿関連QOL調査（IPSS，QOLスコア，UCLA-PCI）を行った． 術前IPSSによりLUTS群， 非LUTS群に分けて，術後排尿QOLの変化を検討した． 【結果】LUTS群は非LUTS群に比べ術後排尿QOLの早い回復を認めた．IPSSおよびQOLスコアは，LUTS群では術前に比べ有意な改善を認めた．術前IPSSは術後QOLスコア回復の有意な予測因子であった． 【結論】LUTS患者は非LUTS患者に比べ，LRPにより術後排尿QOLが早く回復し，排尿症状は術前より改善することが示唆された． |
| Author | 頴川, 晋 田代, 康次郎 木村, 高弘 田畑, 龍治 山田, 裕紀 三木, 健太 三木, 淳 坂東, 重浩 善山, 徳俊 佐々木, 裕 古田, 昭 |
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| References | 9) Deliveliotis C, Protogerou V, Alargof E, et al (2002) Radical prostatectomy : bladder neck preservation and puboprostatic ligament sparing-effects on continence and positive margins. Urology 60 : 855-858 6) Curto F, Benijts J, Pansadors S, et al (2006) Nerve sparing laparoscopic radical prostatectomy : Our technique. Eur Urol 49 : 344-352 12) Gandaglia G, Suardi N, Gallina A, et al (2012) Preoperative erectile function represents a significant predictor of postoperative urinary continence recovery in patients treated with bilateral nerve sparing radical prostatectomy. J Urol 187 : 569-574 10) Rocco B, Gregori A, Stener S, et al (2007) Posterior reconstruction of the rhabdosphincter allows a rapid recovery of continence after transperitoneal video laparoscopic radical prostatectomy. Eur Urol 51 : 996-1003 18) Homma Y, Kawabe K, Tsukamoto T, et al (1997) Epidemiologic survey of lower urinary tract symptoms in Asia and Australia using the international prostate symptom score. Int J Urol 4 : 40-46 3) Tan GY, Jhaveri JK, Tewari AK (2009) Anatomic restoration technique : a biomechanics-based approach for early continence recovery after minimally invasive radical prostatectomy. Urology 74 : 492-496 17) 田中宣道, 平尾佳彦, 藤本清秀, 他 (2013) 治療がQOLに与える影響 : EPICによる治療後QOLの評価, Jpn J Endourol 26 : 193-199 19) Choi EY, Jeong J, Kang DI, et al (2011) Impact of robot-assisted radical prostatectomy on health-related quality of life in patients with lower urinary tract symptoms. Int J Urol 18 : 297-303 20) Kim JH, Ha YS, Jeong SJ, et al (2013) Impact of robot-assisted radical prostatectomy on lower urinary tract symptoms and predictive factors for symptom changes : a longitudinal study. Urology 81 : 787-793 15) Konety BR, Sadetsky N, Carroll PR, et al (2007) Recovery of urinary continence following prostatectomy : The impact of prostate volume－analysis of date from the CaPSURETM database. J Urol 177 : 1423-1426 4) Menon M, Kaul S, Bhandari A, et al (2005) Potency following robotic radical prostatectomy : a questionnaire based analysis of outcomes after conventional nerve-sparing and prostatic fascia sparing technique. J Urol 174 : 2291-2296 5) Stolzenburg JU, Rebenalt R, Tannapfel A, et al (2006) Intrafascial nerve-sparing endoscopic extraperitoneal radical prostatectomy. Urology 67 : 17-21 14) Srivastava A, Chopra S, Pham A, et al (2013) Effect of a risk-stratified grade of nerve-sparing technique on early return of continence after robot-assisted laparoscopic radical prostatectomy. Eur Urol 63 : 438-444 8) Sasaki H, Miki J, Kimura T et al (2009) Lateral view dissection of the prostate-urethral junction to reduce positive apical margin in laparoscopic radical prostatectomy. Int J Urol 16 : 664-669 11) Patel VR, Coelho RF, Palmer KJ, et al (2009) Periurethral suspension stitch during robot-assisted laparoscopic radical prostatectomy : description of the technique and continence outcomes. Eur Urol 56 : 472-478 13) Khoder WY, Trottmann M, Stuber A, et al (2013) Early incontinence after radical prostatectomy : a community based retrospective analysis in 911 men and implications for preoperative counseling. Urol Oncol 31 : 1006-1011 1) Guillonneau B, Vallancien G (2000) Laparoscopic radical prostatectomy : the Montsouris technique. J Urol 163 : 1643-1649 16) 日本泌尿器科学会・日本病理学会・日本医学放射線学会編 (2010) 前立腺癌取扱い規約第4版. 金原出版 7) Lowe BA (1997) Preservation of the anterior urethral ligamentous attachments in maintaining post-prostatectomy urinary continence : a comparative study. J Urol 158 : 2137-2141 2) Ficarra V, Novara G, Artibani W, et al (2009) Retropubic, laparoscopic, and robot-assisted radical prostatectomy : a systematic review and cumulative analysis of comparative studies. Eur Urol 55 : 1037-1063 |
| References_xml | – reference: 15) Konety BR, Sadetsky N, Carroll PR, et al (2007) Recovery of urinary continence following prostatectomy : The impact of prostate volume－analysis of date from the CaPSURETM database. J Urol 177 : 1423-1426 – reference: 3) Tan GY, Jhaveri JK, Tewari AK (2009) Anatomic restoration technique : a biomechanics-based approach for early continence recovery after minimally invasive radical prostatectomy. Urology 74 : 492-496 – reference: 1) Guillonneau B, Vallancien G (2000) Laparoscopic radical prostatectomy : the Montsouris technique. J Urol 163 : 1643-1649 – reference: 20) Kim JH, Ha YS, Jeong SJ, et al (2013) Impact of robot-assisted radical prostatectomy on lower urinary tract symptoms and predictive factors for symptom changes : a longitudinal study. Urology 81 : 787-793 – reference: 7) Lowe BA (1997) Preservation of the anterior urethral ligamentous attachments in maintaining post-prostatectomy urinary continence : a comparative study. J Urol 158 : 2137-2141 – reference: 19) Choi EY, Jeong J, Kang DI, et al (2011) Impact of robot-assisted radical prostatectomy on health-related quality of life in patients with lower urinary tract symptoms. Int J Urol 18 : 297-303 – reference: 2) Ficarra V, Novara G, Artibani W, et al (2009) Retropubic, laparoscopic, and robot-assisted radical prostatectomy : a systematic review and cumulative analysis of comparative studies. Eur Urol 55 : 1037-1063 – reference: 13) Khoder WY, Trottmann M, Stuber A, et al (2013) Early incontinence after radical prostatectomy : a community based retrospective analysis in 911 men and implications for preoperative counseling. Urol Oncol 31 : 1006-1011 – reference: 10) Rocco B, Gregori A, Stener S, et al (2007) Posterior reconstruction of the rhabdosphincter allows a rapid recovery of continence after transperitoneal video laparoscopic radical prostatectomy. Eur Urol 51 : 996-1003 – reference: 4) Menon M, Kaul S, Bhandari A, et al (2005) Potency following robotic radical prostatectomy : a questionnaire based analysis of outcomes after conventional nerve-sparing and prostatic fascia sparing technique. J Urol 174 : 2291-2296 – reference: 18) Homma Y, Kawabe K, Tsukamoto T, et al (1997) Epidemiologic survey of lower urinary tract symptoms in Asia and Australia using the international prostate symptom score. Int J Urol 4 : 40-46 – reference: 12) Gandaglia G, Suardi N, Gallina A, et al (2012) Preoperative erectile function represents a significant predictor of postoperative urinary continence recovery in patients treated with bilateral nerve sparing radical prostatectomy. J Urol 187 : 569-574 – reference: 6) Curto F, Benijts J, Pansadors S, et al (2006) Nerve sparing laparoscopic radical prostatectomy : Our technique. Eur Urol 49 : 344-352 – reference: 8) Sasaki H, Miki J, Kimura T et al (2009) Lateral view dissection of the prostate-urethral junction to reduce positive apical margin in laparoscopic radical prostatectomy. Int J Urol 16 : 664-669 – reference: 11) Patel VR, Coelho RF, Palmer KJ, et al (2009) Periurethral suspension stitch during robot-assisted laparoscopic radical prostatectomy : description of the technique and continence outcomes. Eur Urol 56 : 472-478 – reference: 14) Srivastava A, Chopra S, Pham A, et al (2013) Effect of a risk-stratified grade of nerve-sparing technique on early return of continence after robot-assisted laparoscopic radical prostatectomy. Eur Urol 63 : 438-444 – reference: 9) Deliveliotis C, Protogerou V, Alargof E, et al (2002) Radical prostatectomy : bladder neck preservation and puboprostatic ligament sparing-effects on continence and positive margins. Urology 60 : 855-858 – reference: 5) Stolzenburg JU, Rebenalt R, Tannapfel A, et al (2006) Intrafascial nerve-sparing endoscopic extraperitoneal radical prostatectomy. Urology 67 : 17-21 – reference: 16) 日本泌尿器科学会・日本病理学会・日本医学放射線学会編 (2010) 前立腺癌取扱い規約第4版. 金原出版 – reference: 17) 田中宣道, 平尾佳彦, 藤本清秀, 他 (2013) 治療がQOLに与える影響 : EPICによる治療後QOLの評価, Jpn J Endourol 26 : 193-199 |
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| Snippet | 【目的】腹腔鏡下前立腺摘除術（LRP）の下部尿路症状（LUTS）に与える影響を明らかにするため，術前LUTSの有無と排尿QOLの変化について検討した． 【対象および方法】LRPを施行した196例に対し，術前後に排尿関連QOL調査（IPSS，QOLスコア，UCLA-PCI）を行った． 術前IPSSによりLUTS群，... 「要旨」【目的】腹腔鏡下前立腺摘除術(LRP)の下部尿路症状(LUTS)に与える影響を明らかにするため, 術前LUTSの有無と排尿QOLの変化について検討した. 【対象および方法】LRPを施行した196例に対し, 術前後に排尿関連QOL調査(IPSS, QOLスコア, UCLA-PCI)を行った,... |
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| SubjectTerms | QOL 前立腺癌 腹腔鏡下前立腺摘除術 |
| Title | 腹腔鏡下前立腺摘除術の下部尿路症状に与える影響 |
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