前尿道狭窄手术前后性功能状况研究  

Study on male sexual function before and after anterior urethroplasty

作　　者：唐晨野[1] 傅强[1] 

机构地区：[1]上海交通大学附属第六人民医院泌尿外科,上海200233

出　　处：《中国男科学杂志》2012年第7期32-36,共5页Chinese Journal of Andrology

摘　　要：目的研究前尿道成形术对男性性功能的影响，并分析其影响因素。方法采用简明男性性功能量表（BMSFI）对2010年3月至2011年11月在我院接受前尿道成形术的61例男性前尿道狭窄患者的手术前后性功能状况进行调查分析。结果61例患者术后平均勃起功能评分低于术前（P=0．0033），但术后〉1年即恢复至术前水平（P=0．0986）；术后射精功能评分较术前明显提高（P=0．0261）；性欲和总体满意度评分在手术前后无统计学差异。年龄≥40岁者术后勃起功能评分较术前下降（P=0．0339），〈40岁者术后射精功能评分较术前显著提高（P=0．0019）。外伤性尿道狭窄患者术后勃起功能评分较术前下降（P=0．0313），射精功能评分则明显提高（P=0．0313）。患者接受端端吻合术后勃起功能评分较术前下降（P=0．0332），但射精功能评分较术前提高（P=0．0033）；接受移植物替代成形术后同样出现射精功能评分提高（P=0．0192）；而接受皮瓣转移成形术后各项评分均无明显变化。狭窄部位与长度对性功能影响的多因素分析表明仅部位对勃起功能有影响（P=0．0214）。结论前尿道成形术不影响患者的性欲、勃起功能和总体满意度，但可以明显改善射精功能。年龄、狭窄病因、狭窄部位以及手术方式等都是重要的影响因素。Objective To evaluate the effect of anterior urethroplasty on sexual function of male patients with anterior urethral stricture （AUS）, and analyze its correlated factors. Methods A total of 61 male patients who underwent anterior urethroplasty in our hospital between March 2010 and November 2011 were enrolled in the stuy. Their sexual function before and after surgery was evaluated respectively with the Brief Male Sexual Function Inventory （BMSFI）. Results Of all the 61 patients, mean erectile function （EF） score after surgery was lower than that before surgery （P = 0.0033）, and decrease in EF score was seen only in patients with the postoperative period less than 1 year （ P = 0.0273）; ejaculatory function （EjF） score significantly increased after surgery （P = 0.0261）; and no statistical differences were found in scores of sexual drive （SD） and overall satisfaction （OS） before and after surgery. EF score of patients with age ≥ 40 years decreased postoperatively （P = 0.0339）; EjF score of patients with age 〈40 years increased postoperatively （P = 0.0019）. The EF score of patients with traumatic AUS decreased postoperatively （P = 0.0313）, but EjF score significantly increased after surgery （P = 0.0313）. EjF scores of patients treated with anastomotic urethroplasty and graft urethroplasty all increased postoperatively （P = 0.0033,, 0.0192）; and EF score decreased postoperatively in the former （P = 0.0332）; no significant change in sexual function score was seen in patients who accepted skin flap urethroplasty. Multivariate analysis showed that there was a correlation between stricture location and change in EF. Conclusion Anterior urethroplasty has little effects on SD, long-term EF, and OS, but a significant improvement in EjF. Age, etiology and location of urethral stricture, and skill of urethroplasty are all important affected factors.

关 键 词：前尿道成形术 尿道狭窄 性功能 

分 类 号：R699.6[医药卫生—泌尿科学] R698[医药卫生—外科学]