Objective: To analyze the construction and clinical guiding value of nomogram prediction model for urinary incontinence (UI) after plasma kinetic enucleation of the prostate (PKEP) in patients with benign prostatic hyperplasia（BPH）.
Methods: The clinical data of 250 BPH patients admitted to our hospital from December 2021 to April 2023 were retrospectively analyzed. According to the postoperative UI, they were divided into UI group (n=68) and no-UI group (n=182). The general and clinical data of the two groups were compared, and the influencing factors of postoperative UI in patients with BPH were analyzed by multivariate Logistic regression. Using the "rms" software package in R version 3.5.2, the Nomogram prediction model of UI risk in patients with BPH after operation was drawn, and the diagnostic efficiency of the model was evaluated by the receiver's operating characteristics (ROC) curve.
Results: The proportion of patients with age ≥65 years old, diabetes and preoperative UI in UI group was significantly higher than that in no-UI group (P<0.05). The preoperative membranous urethra (MUL) level of patients in UI group was significantly lower than that in no-UI group, and the proportion of bladder dysfunction decompensation, preoperative prostate volume and operation time were significantly higher than those in no-UI group (P<0.05). Multivariate Logistic regression analysis showed that patients' age ≥65 years, diabetes, preoperative UI, bladder dysfunction decompensation, preoperative prostate volume and operation time were the risk factors for postoperative UI in patients with BPH, and the preoperative length of membranous urethra (MUL) was the protective factor for postoperative UI in patients with BPH (P<0.05). The Nomogram prediction model of postoperative UI of patients with BPH was established. The ROC curve analysis showed that the AUC of Nomogram prediction model for predicting postoperative UI of patients with BPH was 0.826 (95% CI 0.798－0.934) (P<0.05).
Conclusion: Age ≥65 years old, diabetes, preoperative UI, bladder dysfunction decompensation, preoperative prostate volume and operation time are closely related to postoperative UI in patients with BPH. MUL before operation is a protective factor for postoperative UI in patients with BPH. Based on the above factors, it is of certain value to construct Nomogram prediction model in predicting postoperative UI in patients with BPH, which can help predict postoperative conditions of patients and adjust treatment plans in time.
Keywords: plasma prostatectomy; benign prostatic hyperplasia; urinary incontinence; nomogram prediction model; value.