不同手术方法治疗大体积前列腺增生术后尿失禁、性功能变化的对比研究  

Effect of different surgical methods on urinary incontinence and sexual function in patients with massive prostatic hyperplasia

作　　者：姜卫东[1,2] 袁平成 JIANG Weidong;YUAN Pingcheng(Department of Urology,Huangshi Central Hospital,The Hospital Affiliated to Hubei Polytechnic University,Edong Health-Care Group,Huangshi 435000,Hubei,China;Hubei Provincial Key Laboratory of Occurrence and Intervention of Kidney Disease,Huangshi 435000,Hubei,China)

机构地区：[1]鄂东医疗集团黄石市中心医院(湖北理工学院附属医院)泌尿外科,湖北黄石435000 [2]肾脏疾病发生与干预湖北省重点实验室,湖北黄石435000

出　　处：《中国性科学》2019年第5期27-30,共4页Chinese Journal of Human Sexuality

摘　　要：目的对比分析不同手术方法治疗大体积前列腺增生术后尿失禁、性功能变化。方法选取2015年1月至2017年1月鄂东医疗集团黄石市中心医院(湖北理工学院附属医院)诊治的94例大体积前列腺增生患者作为研究对象。按照随机表法分为A组和B组,每组47例。A组采用经尿道前列腺等离子切除术,B组采用经尿道前列腺电切术治疗。比较两组手术时间、术后留置导尿管时间及住院时间,术前和术后6个月IPSS评分、残余尿量、Qmax和QOL评分变化,术后尿失禁发生和术后术后6个月性功能障碍发生情况。结果 A组手术时间、术后留置导尿管时间及住院时间均短于B组,差异具有统计学意义(P<0.05)。两组术后6个月IPSS评分、残余尿量和QOL评分降低而Qmax增加(观察组:t=39.3588、104.5085、37.9827、8.8270,对照组:t=26.4814、84.0084、32.4105、6.1279),差异具有统计学意义(P<0.05);A组术后6个月IPSS评分、残余尿量和QOL评分低于B组而Qmax高于B组(t=6.1208、10.2366、8.9515、7.0501,P<0.05)。A组术后尿失禁发生率(2.13%)低于B组(19.15%),差异具有统计学意义(P<0.05)。A组术后6个月性功能障碍发生率(10.64%)低于B组(33.40%),差异具有统计学意义(P<0.05)。结论大体积前列腺增生患者采用经尿道前列腺等离子切除术相比于经尿道前列腺电切术治疗术后尿失禁发生少,且性功能障碍少,具有重要研究价值。ObjectiveTo compare and analyze the changes in urinary incontinence and sexual function of patients with massive prostatic hyperplasia after different kinds of operation. Methods94 patients with massive prostatic hyperplasia in our hospital from January 2015 to January 2017 were selected.According to the random table method, they were divided into group A and group B, with 47 cases in each group. Group A received transurethralplasma resection of prostate, and group B received transurethral resection of prostate. The catheter indwelling time, hospital stay and operation time were compared between the two groups.Changes in IPSS score, residual urine volume, Qmax score and QOL score between before and 6 months after surgery, the incidence of postoperative urinary incontinence and sexual dysfunction at 6 months after surgery were compared. ResultsThe operation time, the indwelling catheter time and the length of hospital stay in group A were shorter than these in group B (P<0.05). IPSS score, residual urine volume and QOL scoreat 6 monthsafter surgery decreased in the two groups and Qmax increased (group A:t=39.3588, 104.5085, 37.9827, 8.8270, group B:t=26.4814, 84.0084, 32.4105, 6.1279, P<0.05). At 6 months after surgery, IPSS score, residual urine volume and QOL score in group A were lower than these in group B and Qmaxin group A was higher than that of group B (t=6.1208, 10.2366, 8.9515, 7.0501, P<0.05). The incidence of urinary incontinence after operation in group A (2.13%) was lower than that in group B (19.15%)(P<0.05). The incidence of sexual dysfunction at 6 months after operation in group A (10.64%) was lower than that in group B (33.40%)(P<0.05). ConclusionsCompared with transurethral resection of prostate, transurethral plasma resection of prostate for patients with large volume benign prostatic hyperplasia is of low incidence of postoperative urinary incontinence and sexual dysfunction, which has important research value.

关 键 词：不同手术方法 大体积前列腺增生 尿失禁 性功能 

分 类 号：R698[医药卫生—泌尿科学]