尿道端端吻合术对外伤性尿道狭窄患者勃起功能影响的临床研究  

The Clinical Investigation of the Effect on Erectile Function in Traumatic Urethral Stricture Patients with End-to-End Anastomotic Urethroplasty

作　　者：唐晨野[1] 傅强[2] 

机构地区：[1]苏州大学医学部,江苏苏州215006 [2]上海交通大学附属第六人民医院泌尿外科

出　　处：《临床泌尿外科杂志》2011年第8期579-583,共5页Journal of Clinical Urology

摘　　要：目的:研究尿道端端吻合术对外伤性尿道狭窄患者勃起功能的影响。方法:对41例采用尿道端端吻合术治疗的骨盆骨折导致尿道损伤(PFUDD)相关尿道狭窄患者手术前后两个阶段进行血管活性药物注射后阴茎血流彩色多普勒超声波(PPUD)检查和国际勃起功能指数-5(11EF-5)间卷调查,并对数据进行统计学分析。结果:所有41例患者手术前后的IIEF-5评分无显著差异,且勃起功能无明显变化者占大多数,约为56%。各年龄组、狭窄长度组及狭窄部位组患者手术前后的IIEF-5评分均无显著差异,但术后勃起功能提高组、不变组和降低组3组间的狭窄长度差异有统计学意义(2.16±1.49 vs 2.28±0.88 vs 3.50±1.53,P=0.0134),且差异主要存在于降低组与提高组或不变组之间(P=0.0129,0.0165)。轻度及中低度ED组患者术后IIEF-5评分出现明显下降(13.86±1.88 vs 11.43±3.37,P=0.0202),而中度及重度ED组患者则无明显变化。非血管性ED组患者手术前后的IIEF-5评分差异有统计学意义(14.88±1.81 vs 10.88±4.02,P=0.0103),动脉性和静脉性ED组患者手术前后评分则无明显差别。结论:尿道端端吻合术对PFIDD等外伤相关尿道狭窄患者的勃起功能没有显著影响,患者术后勃起功能的变化情况与狭窄长度、术前性功能状态等有关,而与患者年龄、狭窄部位等没有明确的关系。Objective：To evaluate the the effect of end to-end anastomotic urethroplasty on erectile function of traumatic urethral stricture patients. Methods： A total of 41 urethral stricture patients with PFUDD were evaluated with Pharmacopenile Duplex Ultrasonograpgy （PPUD） and International Index of Erectile Function-5 （IIEF-5） pre and post end-to-end anastomotic urethroplasty respectively, These database were analyzed statistically. Results：Of all the 41 patients,there was a insignificant difference on IIEF-5 scores between preoperation and postoperation, and the patients whose erectile function didn＇t change significantly were in the majority,about 56%. In every age group,every stricture length group or every stricture location group,there was a insignificant difference on IIEF-5 scores between preoperation and postoperation; but there was a significant difference on stricture lengthamong pa- tients whose erectile function postoperatively improved, unchanged and decreased（2.16±1.49 vs 2.28± 0.88 vs 3. 50±1.53, P = 0. 0134） ;and the difference was mainly between the decreased and the improved, or the decreased and the unchanged（ P = 0. 0129,0. 0165）. The patients who had mild ED or mild to moderate ED had a significant decline on IIEF-5 scores after surgery（13.86±1.88 vs 11.43±3.37, P =0. 0202）,while the patients who suf- fered from moderate ED or severe ED had an insignificant change postoperatively on IIEF-5 scores. There was a significant difference on IIEF-5 scores of patients with non-vasculogenic ED between preoperation and postopera- tion（14.88±1.81 vs 10.88±4.02, P =0. 0103） ;but of patients with arterial ED or venous ED,there was a insig- nificant difference on IIEF-5 scores between preoperation and postoperation. Conclusions： The erectile function of traumatic urethral stricture patients such as patients with PFUDD is little affected by end-to-end anastomotic ure- throplasty. Some factors like stricture length and preoperative sexual function status will influenc

关 键 词：尿道端端吻合术.夕h伤性尿道狭窄 勃起功能 

分 类 号：R698[医药卫生—泌尿科学]