前尿道狭窄手术前后射精功能状况及影响因素研究  

Study on ejaculatory function and related influencing factors before and after anterior urethroplasty

作　　者：唐晨野[1,2] 傅强[2] 郭晓[1] 

机构地区：[1]浙江省嘉兴市第二医院泌尿外科,浙江嘉兴314000 [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》2014年第2期146-149,共4页Journal of Clinical Urology

摘　　要：目的:研究男性前尿道狭窄患者尿道成形术前后的射精功能(EjF)状况,并分析相关影响因素。方法:采用男性性健康问卷射精功能障碍部分(MSHQ-EjD)对41例成功接受开放性尿道成形术治疗的男性前尿道狭窄患者手术前后的EjF状况进行调查分析。结果:41例患者中,射精功能障碍(EjD)者由术前的20例(48.78%)减少至术后的15例(36.59%);患者总体EjF评分在术后显著提高(P=0.0466),症状困扰评分在手术前后的差异无统计学意义(P=0.1162)。术前EjD患者的EjF评分在术后显著提高(P=0.0003),症状困扰评分显著下降(P=0.0220),EjF正常患者的EjF评分和症状困扰评分均未在术后出现明显的变化(P=0.0640,0.7708)。年龄<40岁患者的EjF评分在术后显著提高(P=0.0279),而≥40岁患者的EjF评分提高不明显(P=0.6033),两组患者的症状困扰评分在手术前后均无明显差异(P=0.1467,0.4973)。球部尿道狭窄患者中的11例(91.67%)接受尿道端端吻合术,术后EjF评分显著提高(P=0.0117),但症状困扰评分下降不明显(P=0.0703);阴茎部尿道狭窄患者中的10例(34.48%)接受带蒂皮瓣尿道成形术,19例(65.52%)接受游离移植物尿道成形术,术后EjF评分和症状困扰评分均未出现明显的变化(P=0.6912,0.7093)。结论:男性前尿道狭窄患者存在一定的射精问题,前尿道成形术可以改善患者的EjF,但只见于术前存在EjD、年龄较小或球部尿道狭窄的患者。Objective： To evaluate the male ejaculatory function （EjF） before and after anterior urethroplasty, and analyze its influencing factors. Method： A total of 41 male patients who benefitted from anterior urethroplasty were enrolled in this study, and the Male Sexual Health Questionnaire Ejaculatory Dysfunction （MSHQ-EjD） was used for subjectively assessing their EjF before and after urethroplasty respectively. Result： The number of pa- tients with ejaculatory dysfunction （EjD） declined from 20 （48.78 %） to 15 （36.59 %） after urethroplasty. Of all the 41 patients, EjF score increased significantly after surgery （P= 0. 0466）, while bother score did not change postoperatively （P = 0.1162）. Both EjF score and bother score changed significantly after surgery in patients with EjD （P= 0. 0003, 0. 0220）, but not in patients with normal EjF （P= 0. 0640, 0. 7708）. Pre- and postoperative EjF scores differed significantly in patients with age 〈 40 years old （P= 0. 0279）, but pre- and postoperative bother scores did not （P= 0. 1467）. Neither EjF score nor bother score of patients with age ≥ 40 years old changed postoperatively （P = 0. 6033, 0.4973）. EjF score increased significantly postoperatively （P = 0.0117） in patients with bulbar urethral stricture of whom 11 （91.67%） accepted end-to-end anastomotic urethroplasty, but it did not change postoperatively （P= 0. 6912） in patients with penile urethral stricture of whom 10 （34.48%） ac- cepted skin flap urethroplasty and 19 （65.52%） accepted graft urethroplasty. Moreover, bother score did not change postoperatively in patients with bulbar or penile urethral stricture （P= 0. 0703, 0. 7093）. Conclusion： Male patients with anterior urethral stricture suffer from ejaculatory problem to some extent. Anterior urethroplasty can improve EjF only in patients with EjD, younger age, or bulbar urethral stricture.

关 键 词：前尿道狭窄 尿道成形术 射精功能 

分 类 号：R699.6[医药卫生—泌尿科学]