不同手术方法治疗老年前列腺增生合并膀胱结石效果及对患者性功能的影响  

Comparative study on the effect on postoperative sexual function of different surgical treatment for prostate hyperplasia patients complicated with bladder stones

作　　者：郁兆存[1] 黄华生[1] 陈早庆[1] 郑哲明[1] 邵志强[2] 

机构地区：[1]广东医学院附属东莞市厚街医院泌尿外科,广东东莞523945 [2]中国人民解放军总医院第一附属医院泌尿外科,北京100000

出　　处：《中国性科学》2017年第4期10-13,共4页Chinese Journal of Human Sexuality

摘　　要：目的:对比研究两种不同手术方法治疗老年前列腺增生(BPH)合并膀胱结石的临床疗效及对患者性功能的影响。方法:选取2014年1月至2016年1月期间我院住院接受手术治疗的老年BPH合并膀胱结石患者60例,按照数字随机表法分为两组:观察组30例接受经尿道前列腺双极等离子电切术(PKPP)联合钬激光碎石术治疗,对照组30例采用经尿道前列腺电切术联合气压弹道碎石治疗,对比两组的临床疗效及性功能。结果:观察组的术中出血量、术后膀胱冲洗时间、导尿管留置时间与住院时间均较对照组明显降低(P<0.05);观察组的取石成功率为96.67%,明显高于对照组的70.00%(P<0.05);术后观察组的残余尿量、IPSS评分均明显低于对照组(P<0.05);术后观察组的残余尿量、IPSS评分均明显低于对照组(P<0.05);术后观察组的IIEF-5评分明显高于对照组(P<0.05),而勃起功能障碍发生率为6.67%,明显低于对照组的20.00%(P<0.05);观察组的性欲减退及逆行射精率分别为3.33%、40.00%,与对照组的6.67%、43.33%比较差异无统计学意义(P>0.05)。结论:PKPP联合钬激光碎石治疗老年BPH合并膀胱结石安全可靠、疗效确切且对性功能的影响较小,值得临床推广应用。Objectives：To compare the clinical efficacy of two different surgical treatments for patients withprostatic hyperplasia（BPH） and bladder stones and the impact on patients＇ sexual function. Methods：60 elderly patients with BPH and bladder stones in our hospital from January 2014 to January 2016 were selected and randomly assigned into two groups,each of 30 cases. The observation group received transurethral bipolar plasma resection（PKPP） joint holmium laser lithotripsy,and the control group used transurethral resection combined with pneumatic lithotripsy. The clinical efficacy and sexual function of the two groups were compared. Results：The blood loss,postoperative bladder irrigation time,catheterization time and hospital stay in observation group was significantly lower than that of control group（P〈0. 05）. The stone success rate of observation group was 96. 67%,significantly higher than the 70. 00% in the control group（P〈0. 05）. The postoperative residual urine volume and IPSS scores in the observation group were significantly lower than that of the control group（P〈0. 05）. The postoperative group IIEF-5 score was significantly higher（P〈0. 05） and the erectile dysfunction was significantly lower in the observation group compared with those in the control group（P〈0. 05）. Loss of libido,and retrograde ejaculation rate was 3. 33% and 40. 00% in the observation group and 6. 67% and 43. 33% in the control group,without statistically significant difference（P〉0.05）. Conclusion：PKPP holmium laser lithotripsy treatment of elderly patients with BPH and bladder stones is safe,reliable and effective,with less impact on sexual function,thusly worthy of clinical application.

关 键 词：前列腺增生 膀胱结石 经尿道前列腺双极等离子电切术 气压弹道碎石 钬激光碎石 

分 类 号：R697.32[医药卫生—泌尿科学]