性活跃男性患者膀胱癌根治+回肠膀胱术后25例勃起功能现状调查  

A survey on erectile function of 25 sexually active male patients receiving laparoscopic radical cystectomy and urete roileal urinary divertion

作　　者：刘玖玲[1] 陈力[1] 曾光[1] 田斌群[1] 

机构地区：[1]武汉大学中南医院泌尿外科,430071

出　　处：《疑难病杂志》2014年第3期268-270,共3页Chinese Journal of Difficult and Complicated Cases

基　　金：武汉大学中南医院国家临床护理重点专科基金资助项目(No.H201215)

摘　　要：目的调查性活跃男性患者行腹腔镜膀胱癌根治+回肠膀胱术后勃起功能的现状,为进一步采取医疗干预措施提供参考和依据。方法 2010年8月—2012年3月接受腹腔镜膀胱癌根治+回肠膀胱术的25例已婚男性患者,术前性功能全部正常,定义其为性活跃男性,其中10例接受保留性神经膀胱癌根治+回肠膀胱术,15例接受非保留性神经膀胱癌根治+回肠膀胱术。对25例患者术前采用国际勃起功能问卷(IIEF-5)进行勃起功能评估,术后结合IIEF-5并参考男子性功能问卷(O'Leary 1995)自行设计调查问卷进行术后勃起功能及相关情况调查。结果与术前比较,25例患者术后12个月均无法达到可以插入阴道的勃起。IIEF-5总分:保留性神经组10例患者从术前(20.60±2.22)分降至术后(1.90±1.73)分,非保留性神经组15例患者从术前(18.73±3.83)分降至术后(3.20±4.87)分,2组术前与术后比较差异均有统计学意义(P<0.01)。2组术后自行设计量表总分比较差异无统计学意义(6.40±0.84 vs.6.20±0.78,P>0.05)。结论膀胱癌根治+回肠膀胱术后男性勃起功能障碍的发生率较高。Objective To evaluate the erectile function in sexually active male patients receiving laparoscopic radical cystectomy （LRC） and ureteroileal urinary divertion to provide an additional reference for medical intervention .Methods From August 2010 to March 2012, 25 cases of bladder cancer patients who were married men underwent laparoscopic radical＋ileal neobladder, all patients with the normal pre-operative sexual function , defined as sexually active males , 10 cases re-ceived neurological reservations bladder cancer radical ＋ileal neobladder and 15 patients received non-reserved neurological bladder cancer cure ＋ileal neobladder.Before surgery, assessed these 25 patients erectile function by using the International Index of Erectile Function Questionnaire （IIEF-5）, after surgery combined with IIEF-5 with reference to male sexual function questionnaire （O’Leary 1995）, self-designed questionnaire for post -operative erectile function and related survey were carried out.Results Compared with pre-operative, after 12 months, post-operative 25 cases were unable to achieve an erection can be inserted into the vagina.IIEF-5 total： Reserved neurological group of 10 patients from preoperative （20.60 ＆#177;2.22） points to postoperative （1.90 ＆#177;1.73） points, the non-reserved neurological group of 15 patients from preoperative （18.73 ＆#177;3.83） points to postoperative （3.20 ＆#177;4.87） points, there were significantly different between the two groups before and after surgery （ P ＆lt;0.01）.There was no statistically significant difference of 2 group self-designed total score （6.40 ＆#177;0.84 vs.6.20 ＆#177; 0.78, P ＆gt;0.05）.Conclusion There are higher incidence of erectile dysfunction after radical cystectomy and ureteroileal u -rinary divertion.

关 键 词：膀胱癌根治术 回肠膀胱术 保留性神经 勃起功能障碍 

分 类 号：R737.14[医药卫生—肿瘤]