Construction and validation of a risk prediction model for bladder spasm after radical prostatectomy

LIAO Xiaohong; WU Jinhua; ZENG Qiuping; HE Yanfei; WANG Linfang

doi:10.12102/j.issn.1009-6493.2023.24.008

Abstract：Objective:To explore the risk factors of bladder spasm after radical prostatectomy in patients with prostate cancer,and to establish and verify the risk early warning model.Methods:From January 2020 to September 2021,120 patients undergoing radical prostatectomy in our hospital were selected.According to whether bladder spasm occurred after operation,they were divided into occurrence group(n=32)and non-occurrence group(n=88).Logistic regression analysis was performed on possible related factors,and a nomogram risk model was constructed and verified.Results:The incidence of bladder spasm after radical prostatectomy in 120 patients with prostate cancer was 26.67％.Age,BMI,preoperative IPSS score and catheter retention time were independent risk factors for bladder spasm after radical prostatectomy(P<0.05).Pelvic floor muscle training,preservation of prostate urethra and preservation of bladder neck were independent protective factors(P<0.05).The results of Hosmer-Lemeshow goodness of fit test showed that x2= 9.052,P=0.338;the area under the ROC curve was 0.981(P<0.001,95％CI 0.956-1.000),the sensitivity was 90.60％,the specificity was 97.70％,the maximum Youden index was 0.883,the overall trend of the model correction curve was close to the ideal curve,and the clinical application accuracy was 79.52％.The decision curve(DCA)analysis showed that the prediction model showed a positive net benefit when the threshold was 0.10-0.92.Conclusions:The occurrence of bladder spasm after radical prostatectomy in patients with prostate cancer is affected by multiple factors.The risk warning model established according to the factors has good predictive efficacy.