HoLEP改良操作对尿失禁与性功能的影响分析  

Effects of the modified HOLEP on urinary incontinence and sexual function

作　　者：张峻峰 周彦 杨正青 程辉 薄隽杰[2] Zhang Junfeng;Zhou Yan;Yang Zhengqing;Cheng hui;Bo Junjie(Department of Urology,Shanghai Yangsi Hospital;Department of Urology,Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine)

机构地区：[1]上海杨思医院泌尿外科,上海200126 [2]上海交通大学医学院附属仁济医院泌尿科,上海200001

出　　处：《中国男科学杂志》2021年第2期46-49,共4页Chinese Journal of Andrology

摘　　要：目的探讨改良保留尿道黏膜经尿道钬激光前列腺剜除术(holmium laser enucleation of prostate,HoLEP)治疗前列腺增生症对尿失禁与性功能的影响分析。方法回顾性分析2016年2月到2019年6月257例前列腺增生症患者,此257名患者术后均有性生活,122例行保留尿道粘膜的HoLEP术(改良组),135例没有保留尿道粘膜的HoLEP术(对照组)。结果对照组和改良组平均手术时间分别为(81.1±21.7)min和(83.6±23.9)min,留置导尿时间分别为(43.7±15.3)h和(44.1±17.3)h,平均住院时间分别为(4.5±2.3)d和(4.1±2.7)d,手术前后IIEF-5、IPSS差异均无统计学意义(P>0.05);两组患者术后短暂性尿失禁、逆行射精发生率和术后6月QOL有统计学意义(P<0.05)。结论改良后的钬激光剜除术能有效降低尿失禁、逆行射精的发生率,对患者术后身心恢复有积极作用。Objective To investigate the effects of the modified Holmium laser enucleation of prostate(HOLEP) on urinary incontinence and sexual function of the patients with prostatic hyperplasia. Methods Clinical data of 257 patients with prostatic hyperplasia who admitted in our hospital from February 2016 to June 2019 were retrospectively analyzed. All the patients had sexual life after surgery. Of them, 122 patients receivedthe modified HoLEP with urethral mucosa preservation(the improvement group), and the other patients receive HoLEP(the control group). Results The average operation times of the control group and the improvement group were(81.1±21.7)min and(83.6±23.9)min, and the average indwelling catheterization times were(43.7±15.3)h and(44.1±17.3)h, the average hospitalization times were(4.5±2.3)d and(4.1±2.7)d.There were no significant differences in IIEF-5 and IPSS before and after operation(P>0.05). There were significant differences in the incidences of transient urinary incontinence and retrograde ejaculation, and QOL at 6 th months after surgery between two groups(P<0.05). Conclusion The modified holmium laser enucleation can effectively reduce the incidence of urinary incontinence and retrograde ejaculation, and has a positive effect on postoperative physical and mental recovery of patients.

关 键 词：钬激光前列腺剜除术 保留尿道黏膜 尿失禁 阴茎勃起功能 逆行射精 

分 类 号：R699.8[医药卫生—泌尿科学]