保留膀胱颈完整性对低龄经尿道前列腺等离子电切术勃起功能及性生活质量的影响  

Impact of preserving the integrity of the bladder neck in transurethral resection of the prostate on erectile function and quality of sex life

作　　者：袁文兵[1] 李颖毅[1] 康启源 

机构地区：[1]宝鸡市人民医院泌尿外科,陕西宝鸡721000

出　　处：《中国性科学》2016年第10期8-11,共4页Chinese Journal of Human Sexuality

摘　　要：目的:探讨保留膀胱颈完整性对低龄经尿道前列腺等离子电切术勃起功能及性生活质量的影响。方法:选择2011年1月至2015年3月本院收治的良性前列腺增生患者80例,按照随机数字法分为两组,各40例,观察组实施经尿道前列腺等离子电切术,并在术中做好膀胱颈完整性的保护;对照组实施经尿道前列腺等离子电切术,但在术中对膀胱颈三角进行切除,随访6个月,比较两组手术相关并发症、两组不同时间点IIEF-5评分、两组术后6个月性功能相关指标及干预后精液常规及DFI指数变化情况。结果:观察组出现阴茎海绵体神经损伤、周围组织损伤及膀胱颈完整性受损的比例显著高于对照组(P<0.05),术后3个月和术后6个月,观察组IIEF-5评分高于对照组(P<0.05),观察组性欲增强及勃起功能增强的比例显著高于对照组(P<0.05),出现逆行射精的比例显著低于对照组(P<0.05),干预后观察组精液中精子密度、精子活动率及精子活力均显著高于对照组(P<0.05),且精子DNA碎片显著少于对照组(P<0.05)。结论:经尿道前列腺等离子电切术保留膀胱颈完整性能显著减少患者术后勃起功能障碍,提高性生活质量,同时还能提高精子质量。Objectives： To investigate the impact of preserving the integrity of the bladder neck in transurethral resection of the prostate on erectile function and quality of life. Methods： 80 patients with benign prostatic hyperplasia（ BPH） from January 2011 to March 2015 in our hospital were randomized into two groups,40 cases in each group. The observation group preserved the integrity of the bladder neck in transurethral resection of the prostate（ TURP） while the control group excised it in TURP. All patients were followed up for 6 months,to compare the incidence of complications,IIEF- 5 score at two different time points and changes in semen and DFI index6 months postoperatively. Results： The incidence of penis nerve injury and damage to surrounding tissue and the integrity of the bladder neck in observation group was significantly higher than control group（ P〈 0. 05）; the IIEF-5 score in observation group was significantly higher 3 and 6 months after treatment（ P〈 0. 05）; the increase in libido and erectile function in observation group was significantly higher than control group（ P〈 0. 05）,while the incidence of retrograde ejaculation was significantly lower than the control group（ P〈 0. 05）; the sperm concentration,sperm motility and sperm viability of observation group after intervention was significantly higher than control group（ P〈 0. 05）,while sperm DNA fragmentation was significantly less than the control group（ P〈 0. 05）.Conclusion： Preserving the integrity of the bladder neck in TURP significantly reduces postoperative erectile dysfunction and improves the quality of sex life and quality of sperm.

关 键 词：保留膀胱颈完整性 低龄 经尿道前列腺等离子电切 勃起功能 性生活质量 

分 类 号：R699.8[医药卫生—泌尿科学]