经尿道精囊镜治疗难治性血精症的应用价值及IIEF-5、CIPE评分分析  

Analysis of the application value and IIEF-5 score and CIPE score of transurethral seminal vesicle in the treatment of refractory hematospermia

作　　者：沈伟 李殷南 孙宾 王乾 Shen Wei;Li Yinnan;Sun Bin;Wang Qian(Department of Urology,Chongming Branch,Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 202150,China)

机构地区：[1]上海交通大学医学院附属新华医院崇明分院泌尿外科,上海202150

出　　处：《国际泌尿系统杂志》2023年第1期114-117,共4页International Journal of Urology and Nephrology

摘　　要：目的探讨经尿道精囊镜(TSV)技术治疗难治性血精症的疗效以及安全性。方法回顾性分析2016年12月至2021年6月在本院诊断为难治性血精症、接受药物治疗半年以上无效反复发作后经TSV治疗的98例患者的临床资料,随访并比较治疗前后患者的精液质量、治疗效果指标以及术后并发症情况。结果所有患者均手术顺利。治疗6个月后随访,患者的精液中红细胞和白细胞数量分别由治疗前的(5.68±0.78)、(12.34±1.71)×10^(6)/mL下降为(0.97±0.45)、(1.43±0.34)×10^(6)/mL(t=2.201、6.970,均P<0.001)。治疗后的国际勃起功能评分表(IIEF-5)评分和性功能中国早泄患者性功能评价表(CIPE)评分均高于治疗前,差异均有统计学意义(t=6.677、15.438,均P<0.001)。98例患者中临床痊愈58例,好转28例,治疗总有效率为87.8%(86/98)。98例患者中出现逆行射精2例,附睾炎4例,未观察到精囊穿孔、射精管反流、直肠尿道瘘等严重并发症。结论采用TSV技术治疗难治性血精症患者不仅可以明确诊断,还能对精囊进行冲洗,在改善血精临床症状和提高性生活质量方面安全有效。Objective To investigate the efficacy and safety of transurethral seminal vesicle scope(TSV)technique in the treatment of recurrent hemospermia.Methods From December 2016 to June 2021,98 patients with hemospermia diagnosed in our hospital who received drug treatment for more than half a year with ineffective and recurrent episodes and treated with TSV were selected for retrospective analysis.The clinical data of the two groups were recorded,followed up and compared the semen quality and treatment effect indicators as well as postoperative complications.Results All patients underwent successful surgery.After 6 months of treatment,the number of red blood cells and white blood cells in semen decreased from(5.68±0.78)and(12.34±1.71)×10^(6)/mL to(0.97±0.45)and(1.43±0.34)×10^(6)/mL(t=2.201,6.970,all P<0.001).After treatment,IIEF-5 scores and CIPE scores of premature ejaculation patients in China were higher than those before treatment,and the differences were statistically significant(t=6.677,15.438,all P<0.001).Of the 98 patients,58 were cured and 28 were improved.The total effective rate was 87.8%(86/98).Among the 98 patients,there were 2 cases of retrograde ejaculation,4 cases of epididymitis,and no seminal vesicle perforation,ejaculatory duct reflux,rectourethral fistula and other serious complications were observed.Conclusions Transurethral seminal vesiculoscopy in the treatment of patients with recurrent hemospermia can not only confirm the diagnosis,but also flush the seminal vesicles,which is safe and effective in improving the clinical symptoms of hemospermia and improving the quality of sexual life.

关 键 词：血精 精囊镜 国际勃起功能指数5 中国早泄患者性功能评价表 

分 类 号：R699.8[医药卫生—泌尿科学]