自慰器辅助行为治疗对自慰射精困难的疗效初探  

Preliminary study on the treatment of masturbation ejaculation difficulty with handheld stimulating device assisted behavior therapy

作　　者：范宇平[1] 马逸[2] 刘国霖[1] 胡烨[1] 黄文强[1] 黄媚媛[1] 滕晓明[1] 

机构地区：[1]同济大学附属第一妇婴保健院生殖医学中心,上海200040 [2]上海交通大学医学院附属仁济医院辅助生殖医学中心

出　　处：《中国男科学杂志》2016年第7期50-53,共4页Chinese Journal of Andrology

摘　　要：目的：回顾性分析男科门诊体外受精（in vitro fertilization, IVF）术前主诉通过自慰取精困难的患者，评价自慰器辅助行为治疗的疗效。方法选择2013年8月至2014年5月在上海市第一妇婴保健院生殖中心行IVF治疗的、有射精困难（排除自慰和性生活均不能射精等情况）的患者53例。由患者及家属自主选择治疗方案，倾向优先器械辅助行为治疗的患者31例，占58.49%。根据选择的治疗方法将患者分为两组，治疗组31例，对照组22例。治疗组患者在治疗期间规律射精频率、保持生活习惯，前2周自行采用自慰器，通过视听刺激于家中尝试取精，后2周每周1~2次于手术取精室进行模拟治疗，成功取精后进行1个月维持治疗。在术前选择冷冻保存精子的患者共39例（治疗组20例，对照组19例）。结果治疗组31例患者，在治疗阶段自行通过自慰器成功取精25例（80.65%）。在手术当日，治疗组成功取精19例（61.29%），使用术前冷冻精子10例（32.26%），手术当日睾丸穿刺取精2例（6.45%）。对照组成功取精7例（31.82%），使用术前冷冻精子12例（54.55%），手术当日睾丸穿刺取精3例（13.64%）。两组患者手术当日取精成功率比较差异有显著统计学意义（P＜0.05）。而在术前冷冻精子的39例患者和未冷冻精子的14例患者手术日取精成功率比较差异无统计学意义（P＞0.05）。结论自慰器辅助行为治疗对自慰射精困难的患者有一定疗效。但如何取得更好的疗效及明确机制尚待进一步大样本、多中心的深入研究。Objective To evaluate the effect of handheld stimulating device assisted behaviour therapy on masturbation ejaculation difficulty of the patients from IVF （in vitro fertilization, IVF） outpatient.Methods Total of 67 cases who complained masturbation ejaculation difficulty during the IVF cycle from August 2013 to May 2014 were selected in the study. The cases who had ejaculation difficulty both in masturbation and sexual life or other determinate factors were ruled out. At last, 53 cases of them were enrolled and divided into two groups according to the treatment method, and the treatment group includes 31 cases. The patients kept regulated ejaculation frequency and living habits. The first 2 weeks these patients use handheld stimulating device and audio-visual stimulation to assist masturbation at home, then the next 2 weeks the patients use the same method to try practice test once or twice a week in hospital. The patients who successfully finished ejaculation after the treatment had a follow-up therapy period for about 1 month. The control group includes 22 cases, 19 cases choose sperm cryopreservation before IVF, 3 cases acquired sperm by testicular puncture. We compare 〈br〉 the success rate of ejaculation on operation day of the two groups.Results The patients of the treatment group included 31 cases, in the treatment phase, 25 cases （80.65%） finished ejaculation successfully by masturbation. The control group included 22 cases. 58.49% of the patients preferred handheld stimulating device assisted behavior therapy. On the operation day, 19 cases （61.29%） finished ejaculation successfully in the treatment group, 10 cases （32.26%） used the frozen sperm before operation, and 2 cases （6.45%） were treated by testicular puncture. In the control group, 7 cases （31.82%） finished ejaculation, 12 cases （54.55%） used the frozen sperm, and 3 cases （13.64%） were treated by testicular puncture. There was a significant difference in the success rate of the two groups of patients （P〈0.

关 键 词：自慰器 行为疗法 受精 体外 射精困难 

分 类 号：R698.2[医药卫生—泌尿科学]