尿道狭窄3种术式手术前后勃起功能状态的临床研究  

Influences of three surgical approaches to urethral stricture on the erectile function of the patients

作　　者：冼志勇[1] 陈庆科[1] 陈汉忠[1] 叶楚津[1] 冯自卫[1] 李东[1] 蒲小勇[1] 王怀鹏[1] 毛向明[2] 刘久敏[1] 

机构地区：[1]广东省人民医院/广东省医学科学院泌尿外科,广东广州510080 [2]北京大学深圳医院泌尿外科,广东深圳518036

出　　处：《中华男科学杂志》2014年第8期706-708,共3页National Journal of Andrology

摘　　要：目的:对3种术式治疗尿道狭窄患者手术前后勃起功能状态进行研究。方法:分别采用3种术式对126例尿道狭窄男性患者进行治疗。35例患者接受尿道狭窄部位阴茎皮瓣重建术,52例患者接受尿道端端吻合术,39例患者接受内窥镜下尿道内切开术。通过电话随访、面访方式,采用国际勃起功能指数问卷(IIEF-5)评分对每组患者术前、术后勃起功能的总体情况进行评价,同时利用夜间阴茎胀大实验(NPT)对患者进行诊断。结果:行尿道狭窄部位阴茎皮瓣重建术组IIEF-5评分术前与术后分别为(17.1±2.6)分和(13.5±4.5)分;行尿道端端吻合术组IIEF-5评分术前与术后分别为(17.1±3.0)分和(11.1±4.8)分;行尿道内切开术组IIEF-5评分术前与术后分别为(17.6±2.2)分和(14.5±4.4)分。与术前相比,3组患者术后IIEF-5评分均显著下降,其差异具有统计学意义(P<0.05)。上述3种术式术后勃起功能障碍发生率分别为8.57%(3/35)、26.92%(14/52)、10.26%(4/39),尿道端端吻合术显著高于其他2种术式(P均<0.05)。结论:3种术式治疗尿道狭窄术后IIEF-5评分均有所下降,与尿道端端吻合术相比,尿道狭窄部位阴茎皮瓣重建术与尿道内切开术术后勃起功能障碍的发生率较低,应注重对适宜术式的选择以确保对患者性功能的有效保护。Objective： To evaluate the impacts of three different surgical approaches to urethral stricture on the erectile function of the patients. Methods： This study included 126 male patients with urethral stricture, 35 treated by substitution urethroplasty （group A）, 52 by anastomotie urethroplasty （group B）, and 39 by internal urethroplasty （group C ）. We evaluated the pre- and post- operative erectile function of the patients using IIEF-5 scores by telephone calls and interviews. We also monitored their nocturnal pe- nile tumescence （NPT）. Results： The IIEF-5 scores in groups A, B and C were 13.5 ±4.5, 11.1 ±4.8 and 14.5 ± 4.41 respec- tively after surgery, all significantly decreased as compared with 17.1 ±2.6, 17.1 ± 3.0 and 17.6 ± 2.2 preoperatively （P 〈 0.05 ）. Conclusion ： All the three surgical approaches can reduce IIEF-5 scores in patients with urethral stricture, but anastomotic urethroplas- ty may induce a higher incidence of erectile dysfunction than the other two approaches.

关 键 词：尿道狭窄 尿道狭窄部位阴茎皮瓣重建术 尿道端端吻合术 尿道内切开术 勃起功能障碍 

分 类 号：R699[医药卫生—泌尿科学]