腹腔镜前列腺癌根治术后电生理技术早期干预恢复控尿功能的临床疗效观察

目的:探讨腹腔镜前列腺癌根治术后电生理技术早期干预恢复控尿功能的临床疗效。方法:选取2021年7月至12月暨南大学附属第一医院泌尿外科5例前列腺癌患者接受腹腔镜前列腺癌根治术，术后3 d采用电生理技术早期干预，年龄（63.20±6.14）岁。术式均为筋膜间腹腔镜前列腺癌根治术，术中膀胱尿道无张力吻合后，行膀胱颈前壁与耻...

Observation of clinical efficacy of early electrophysiological technology intervention in restoring urine control function after laparoscopic radical resection of prostate cancer

Objective　To investigate the clinical efficacy of early electrophysiological technology intervention in restoring urine control function after laparoscopic radical resection of prostate cancer. Methods　Five patients aged (63.20±6.14) years with prostate cancer enrolled in the Department of Urology of The First Affiliated Hospital of Jinan University from July to December 2021 received electrophysiological intervention on the third day after laparoscopic radical resection of prostate cancer. The laparoscopic radical resection of prostate cancer was performed between pelvic fascia and prostatic fascia. Tension-free anastomosis was made between the bladder and proximal urethra, and then the anterior wall of the bladder neck and the pubic prostate ligament were stitched up. On the third day, a medical infrared thermal imaging instrument (PRISM 640A/PRISM 384A) was used to visualize the electrophysiological diagnosis, the individual electrophysiological parameters were selected, and then the precise electrophysiological treatment was conducted (low-frequency neuromuscular therapy instrument model: BioStim pro and BioStim ble Foshan Shanshan Datang Medical Technology Co., LTD.). Electrophysiological treatment parameters and electrode tablet adhesive locations: BB8: 10 Hz/300 µs for arterial circulation, BB16: 2 Hz/280 µs for venous circulation, BB27: 48 Hz/180 µs for arterial circulation, BB30: 10 Hz/480 µs for lymphatic circulation; EE21: 36 Hz/300 µs for vascular smooth muscle; electrode tablets were affixed at "curved bone, triple Yin" acupoints. DD1: 8 Hz/500 µs, 20 Hz/350 µs for classⅠ skeletal muscle, DD211: 25 Hz/500 µs for classⅠ skeletal muscle, DD297: 36 Hz/350 µs for class Ⅱ skeletal muscle, DD211 and DD297 alternatively; electrode tablets were attached to the pelvic floor muscles. CC16: 25 Hz/300 µs for pudendal nerves, CC39: 96 Hz/150 µs for sympathetic nerves, electrode tablets were affixed to the "curved bone, sacral eight points" acupoints, consecutive treatment for 5-9 times. After treatment, International Incontinence Advisory Committee Incontinence Questionnaire (ICI-Q-SF) score, Quality of Incontinence Questionnaire (I-QOL) score, and 24 h urinary pad usage in the five patients were recorded. Results　All the patients completed the operation successfully, with the operation time of (5.92±1.35) h, the bleeding volume of (42.00±10.95) ml, and the pelvic drainage tube duration of (4.20±1.10) d. One patient had fever and was cured according to the symptoms. Two weeks later, all the 5 patients had a little urine leakage when coughing vigorously after urinary catheters were removed. Only one patient applied 1 urinary pad on the very day of the extraction of urine tube, and the urinary pad utilized by the patient was less than or equal to 1 piece within 24 hours; another 4 patients did not use the urinary pad after extraction of urine tube, whom were evaluated as the postoperative early recovery of urine control function. The treatment cycle was (7.40±1.52) d, the ICI-Q-SF score was (2.80±1.64), and the I-QOL score was (94.00±3.08). Conclusion　The early electrophysiological technology intervention in restoring urine control function after laparoscopic radical resection of prostate cancer is safe and effective, and it might be expected to become a standard adjuvant therapy in the future.