Mirabegron對機器手臂輔助根治性攝護腺切除術後尿控功能與性功能的影響

黎赫、曹智惟、蒙恩、查岱龍、楊明昕

國防醫學大學三軍總醫院外科部泌尿外科

Mirabegron for Continence and Potency After Robot-Assisted Radical Prostatectomy

Ho Li, Chih-Wei Tsao, En Meng, Tai-Lung Cha, Ming-Hsin Yang

Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan

Purpose: To evaluate whether adding Mirabegron to a standard Tadalafil rehabilitation protocol accelerates urinary continence recovery and improves erectile function after robot-assisted radical prostatectomy (RARP).

Materials and Methods: In this retrospective cohort study, multivariable Cox models and logistic regression analyses were used to evaluate continence recovery. Multivariable linear regression for erectile function recovery was adjusted for baseline IIEF-5 score, age, BMI, hypertension, and diabetes mellitus.

Results: Baseline characteristics were well-balanced. Multivariate Cox regression analysis suggested that Mirabegron use was independently associated with significantly faster continence recovery (Hazard Ratio [HR] 1.59, 95% CI 1.13-2.24, p = 0.007). In a landmark analysis at 3 months, 42.9% of patients in the Mirabegron group achieved complete dryness compared to 13.1% in the Control group (OR 5.11, p < 0.001). Regarding sexual function, the Mirabegron group achieved significantly higher mean IIEF-5 scores at 12 months (adjusted coefficient +0.87, p = 0.023), although the binary potency recovery rate did not reach statistical significance.

Conclusions: In patients with pT2 disease, Mirabegron is independently associated with faster continence recovery and improves long-term erectile function. These findings suggest a dual benefit of β3-adrenergic receptor agonists in early postoperative pelvic floor and penile rehabilitation.