Establishment of an Early Warning Model for Urinary Incontinence after Radical Prostatectomy in Middle-aged and Elderly Patients Based on Clinical Data
Xue Lusha
Li Ping
Wang Yun
Qiu Xuefeng
Pan Jie
Abstract：Objective To establish an early warning model for urinary incontinence(UI)complicating robot-assisted laparoscopic radical prostatectomy(RARP)in middle-aged and elderly patients based on clinical data.Methods A retro-spective analysis was performed on clinical data of 209 middle-aged and elderly patients who underwent RARP at the Affiliat-ed Drum Tower Hospital of Nanjing University Medical School from July 2022 to January 2024.According to the occurrence of UI at 3 months after surgery,the patients were divided into the UI group and non-UI group.The clinical data of the two groups were collected and compared.LASSO-Logistic regression analysis was applied to identify the influencing factors of postoperative UI in middle-aged and elderly patients undergoing RARP.The R software was used to construct a nomogram model.Receiver operating characteristic(ROC)curve and calibration curve were plotted to evaluate the value of the nomo-gram model in predicting the occurrence of postoperative UI.Results Compared with the non-UI group,the UI group had significantly higher proportions of patients with older age,higher body mass index(BMI),preoperative Gleason score of 7 points,postoperative pathological stage T3,preoperative anxiety or depression,decompensated bladder function,and pros-tate volume>40 mL,while the proportion of patients with intraoperative bladder neck preservation was significantly lower(all P<0.05).Age≥70 years,obesity,preoperative prostate volume>40 mL,preoperative Gleason score of 7 points,postoperative pathological stage T3,preoperative anxiety or depression,preoperative decompensated bladder function,and intraoperative bladder neck preservation were independent influencing factors for postoperative UI(all P<0.05).The early warning model for postoperative UI constructed based on the above factors showed a C-index of 0.818 and an area under the curve(AUC)of 0.909(95%CI:0.871-0.947).The calibration curve demonstrated high predictive accuracy of the model.Conclusion Age≥70 years,obesity,preoperative prostate volume>40 mL,preoperative Gleason score of 7 points,post-operative pathological stage T3,preoperative anxiety or depression,preoperative decompensated bladder function,and intra-operative bladder neck preservation are independent influencing factors for postoperative UI.The early warning model con-structed based on these factors has high accuracy and predictive efficacy,which can accurately identify potential high-risk populations at an early stage and facilitate the formulation of preventive measures to reduce the incidence of postoperative UI.
Keywords：clinical dataperioperative datamiddle agedagedrobot-assisted laparoscopic radical prostatecto-myurinary incontinencerisk factorsearly warning model
Publication Date：2025-12-28
Online Publishing Date：2026-03-11(First online date of this platform, not the publication date of the document)
Pages：6( 416-421 )