120瓦二微米激光前列腺汽化剜除术与经尿道前列腺电切术对性功能影响  

Impact on sexual function of 120 W 2 μm continuous-wave laser vapoenucleation versus and transurethral resection of the prostate

作　　者：王毓斌[1] 邵晋凯[1] 吕永安[1] 李晓东[1] 

机构地区：[1]山西省人民医院泌尿外科,太原030012

出　　处：《中国医师进修杂志》2014年第5期13-16,共4页Chinese Journal of Postgraduates of Medicine

基　　金：山西省人民医院青年科研基金（2010-049）

摘　　要：目的 评估120W2 μm激光前列腺汽化剜除术与经尿道前列腺电切术（TURP）治疗良性前列腺增生（BPH）对患者性功能的影响.方法 选择122例BPH患者,63例行120W2 μm激光前列腺汽化剜除术治疗为2μm激光组,59例行TURP治疗为TURP组.术前、术后12个月评估性功能,采用国际勃起功能指数（IIEF）评分和自行设计射精功能问卷,IIEF评分包括5个方面：勃起功能、性欲、性高潮、性满意度及总体满意度.结果 两组术前IIEF各项评分比较差异无统计学意义（P＞0.05）.两组术前与术后12个月勃起功能、性满意度、性欲、总体满意度评分比较差异无统计学意义（P＞0.05）,但两组术后12个月性高潮评分明显低于术前[2μm激光组：（5.9±1.5）分比（8.6±2.7）分;TURP组（5.5±1.6）分比（8.7±1.8）分],差异有统计学意义（P＜0.05）.多元线性回归分析显示两组勃起功能评分与国际前列腺症状评分、生存质量评分、最大尿流率呈线性正相关（P＜0.05）.Logistic回归分析显示逆行射精的发生与性高潮降低显著相关（P＜0.05）,且可作为120 W2μm激光前列腺汽化剜除术和TURP后性高潮降低的独立预测因子（P＜0.05）.结论 120W2μm激光前列腺汽化剜除术和TURP对性功能影响相似,两种术式在一定程度上改善勃起功能,但降低患者的性高潮评分,其主要原因可能是术后逆行射精的发生.Objective To evaluate the impact of 120 W 2 μ m continuous-wave laser vapoenucleation versus and transurethral resection of the prostate （TURP） in patients with symptomatic benign prostatic hyperplasia （BPH） on sexual function.Methods One hundred and twenty-two patients with BPH were selected,63 cases were treated with 120 W 2 μ m continuous-wave laser vapoenucleation versus（2 μ m laser group）,59 cases were treated with TURP（TURP group）.International index of erectile function（IIEF） scores and self-made general assessment questions were completed before and 12 months after treatment to determine the impact on sexual function.IIEF scores included erectile function （EF）,sexual desire,orgasm,sexual satisfaction and overall satisfaction.Results The IIEF scores difference was no significant before treatment between two groups （P ＞ 0.05）.In two groups,there was no significant difference in EF,sexual desire,sexual satisfaction and overall satisfaction score between before treatment and 12 months after treatment（P＞ 0.05）,orgasm score 12 months after treatment was significantly lower than that before treatment [2 μm laser group：（5.9 ± 1.5） scores vs.（8.6 ± 2.7） scores;TURP group：（5.5 ± 1.6） scores vs.（8.7 ± 1.8） scores] （P ＜0.05）.Multiple linear regression analysis showed that two groups EF score and the international prostate symptom score,quality of life score and Q.~ positive linear correlation.Logistic regression analysis showed that the incidence of retrograde ejaculation and orgasm reduced significantly assoeiated（P ＜ 0.05）,as an independent predictor of orgasm reduced after treatment（P ＜ 0.05）.Conclusions There is no difference between these two surgical techniques regarding to impact on sex function.No significant EF improvement after surgery in both groups,but these two techniques can significantly decrease the IIEF orgasmic function domain and this is mainly caused by retrograde ejaculation.

关 键 词：前列腺增生 经尿道前列腺切除术 性功能障碍 生理性 2μm激光 120W 逆行射精 

分 类 号：R699.8[医药卫生—泌尿科学]