高強度聚焦電磁儀器對於機械手臂輔助前列腺根除手術術後禁尿功能之影響

歐弦哲、阮雍順、李經家、李永進、溫聖辰、錢祖名、李香瑩

高雄醫學大學附設中和院區 泌尿部; 高雄醫學大學

Impact of High-intensity Focused Electromagnetic (HIFEM) on Urinary Continence Following Robotic-Assisted Radical Prostatectomy: A Comparative Study

Hsien-Che Ou, Yung-Shun Juan, Ching-Chia Li, Yung-Chin Lee, Sheng-Chen Wen, Tsu-Ming Chien, Hsiang-Ying Lee

Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;

School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

Purpose：This study aimed to assess the impact of High-intensity Focused Electromagnetic (HIFEM) on urinary continence rates following RARP. A comparison was made between patients undergoing pelvic floor exercises alone and those receiving pelvic floor exercise adding HIFEM.

Methods：A total of 39 RARP patients were enrolled with the inclusion criteria of moderate to severe post-operative incontinence. The group comprised 13 patients treated with the pelvic floor exercise with HIFEM and 26 patients performing pelvic floor exercises along with biofeedback. Urinary continence was evaluated using multiple parameters, including the Uroflow, post-void residual (PVR), International Prostate Symptom Score (IPSS), Overactive Bladder Symptoms Score (OABSS), International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-UI SF), Pad test, and Voiding diary, at pre-operation, post-operation 1 week, 1 month, 2 months. Functional outcomes were assessed using the international index of erectile function (IIEF).

Results：Patients treated with the HIFEM exhibited a significant improvement in urinary continence compared to the pelvic floor exercise group(p=0.0467) right after receiving 6 cycles of HIFEM therapy at the period of post-operation 1-month to 2-month. Additionally, OABSS total score(p<0.01), urgency score(p=0.02) and incontinence score(p=0.03) also showed better results in HIFEM group.

Conclusion：Our study suggests that High-intensity Focused Electromagnetic device significantly enhances urinary continence recovery in patients undergoing RARP compared to those practicing pelvic floor exercises alone.