罹患早期攝護腺癌的患者在接受腹腔鏡攝護腺根除術後，有部分患者會出現”張力性尿失禁”的後遺症—在咳嗽、負重甚至單純走動時，因為禁尿功能的受損，尿液會從體內滲漏出來，對生活品質有不小的影響。

根據統計，大部分的術後張力性尿失禁在兩年內會恢復到穩定的狀態，因此如果要針對此種尿失禁進行手術治療，一般建議在攝護腺根除術後觀察兩年，如果尿失禁一直未恢復再進行較為適當。然而，對患者本人來說，等待失禁狀態的改善常常是令人緊張而煎熬的；如果能有一些簡單的指標可預測尿失禁恢復的時間，不但可以讓醫師對預後有比較清楚的估計，對患者也能提供比較清楚的恢復時間表。

此研究為慈濟醫院郭漢崇教授團隊進行的回溯性研究，48名接受腹腔鏡攝護腺根除術的患者在術後接受膀胱攝影及尿路動力學檢查，觀察檢查結果與術後尿失禁恢復的時間有無相關聯。 其結果顯示，當膀胱攝影顯示術後膀胱頸在恥骨聯合上緣以上的時候，患者可以較快恢復禁尿功能(接近八成的患者在3個月內恢復禁尿功能)。此外，在術後尿路動力學檢查中擁有較長的Functional urethra length的患者，也可以較快恢復禁尿功能。

此研究結果可協助醫師在面對腹腔鏡攝護腺根除術造成的尿失禁時，能更精準的預估禁尿功能恢復的預後

Background/Purpose:
To investigate the relationship between post-operative bladder neck levels and urodynamic parameters and their effect on urinary incontinence after laparoscopic radical prostatectomy (LRP).

Methods:
Forty-eight consecutive patients undergoing LRP were retrospectively reviewed. All patients were assessed using retrograde cystography after LRP and were grouped according to their bladder neck position: Level 0: at or above the superior margin of the symphysis pubis (SMSP); Level 1: at <2 cm below SMSP; and Level 2: at >2 cm below SMSP. Urodynamic studies were conducted at baseline as well as at 1 and 3 months post-operatively. Early recovery of urinary continence was defined as no urine leakage or only one pad/day used within 3 months after surgery. Demographic characteristics, changes in urodynamic parameters, and continence outcomes were analyzed.

Results:
Overall rate of early recovery of urinary continence was 33.3%. Patients with higher bladder neck levels experienced a significantly earlier recovery of urinary continence in univariate analysis (77.8%, 29.2%, and 13.3% for bladder neck levels 0, 1, and 2, respectively, p Z 0.004). Patients with early recovery of urinary continence had significantly longer functional profile lengths (FPLs) 1 month post-surgery (21.0 mm vs 14.8 mm, p Z 0.019). Higher bladder neck levels were significantly associated with longer FPLs at 1 month (p Z 0.032).

Conclusion:
Bladder neck level is associated with FPLs at 1 month post-surgery, which is the possible predictor of early recovery of urinary continence after LRP. Patients with longer FPL at 1 month after LRP have a higher rate of early recovery of urine continence.