经尿道前列腺绿激光汽化术对良性前列腺增生患者性功能的影响  

Effect of greenlight laser photoselective vaporization of the prostate on sexual function in patients with benign prostatic hyperplasia of different prostate volumes

作　　者：侯瑞鹏[1] 李健[1] 李昭夷[1] HOU Ruipeng;LI Jian;LI Zhaoyi(Department of Urology,Tianjin Union Medical Center,Tianjin 300121,CHINA)

机构地区：[1]天津市人民医院泌尿外科(南开大学人民医院转化医学研究院),300121

出　　处：《江苏医药》2023年第7期718-721,726,共5页Jiangsu Medical Journal

基　　金：天津市卫健委科技基金(ZC20182)。

摘　　要：目的观察经尿道前列腺绿激光汽化术(PVP)对不同前列腺体积的良性前列腺增生(BPH)患者性功能的影响。方法131例行PVP的BPH患者中,58例患者前列腺体积≥80mL(A组),73例患者前列腺体积<80mL(B组)。术后随访3、6、12个月,采用国际前列腺症状评分(IPSS)、最大尿流率(Qmax)和生活质量评分(QOL评分)评估患者下尿路梗阻改善情况;采用国际勃起功能指数问卷表(IIEF-5)评估患者勃起功能变化;观察患者逆行射精和精液量减少发生情况,评估患者射精功能变化。结果与术前比较,两组患者术后3、6、12个月IPSS、Qmax和QOL评分均改善(P<0.05);两组间术后3、6、12个月IPSS和QOL评分比较均无统计学差异(P>0.05);B组术后3、6个月Qmax高于A组(P<0.05),但两组术后12个月Qmax比较无统计学差异(P>0.05)。与术前比较,A组患者术后3、6、12个月IIEF-5评分降低(P<0.05);B组患者手术前后IIEF-5评分比较差异无统计学意义(P>0.05)。A组患者术后3、6、12个月IIEF-5评分低于B组(P<0.05)。两组术后3、6、12个月逆行射精和精液量减少发生率差异无统计学意义(P>0.05)。结论PVP对大体积BPH患者的勃起功能影响较大,而对小体积BPH患者勃起功能无显著影响。该术式对患者射精功能具有一定影响,但与前列腺体积无关。Objective To observe the effect of greenlight laser photoselective vaporization of the prostate(PVP)on sexual function in the patients with benign prostatic hyperplasia(BPH)of different prostate volumes.Methods PVP was performed in i31 patients with BPH,of whom 58 patients had prostate volume≥80 mL(group A)and 73 patients had prostate volume<80 mL(group B).The patients were followed up for 3,6 and 12 months.The improvement of lower urinary tract obstruction was evaluated with the international prostate symptom score(IPSS),the maximum urinary flow rate(Qmax)and the quality of life score(QOL).The international index of erectile function(IIEF-5)was used to evaluate the changes of the erectile function,and the changes of the patient's retrograde ejaculation and semen volume reduction were observed to evaluate the changes of the patient's ejaculation function.Results Compared with preoperation,the IPSS,Qmax,and QOL score were improved at 3,6,and 12 months after operation in the two groups(P<0.05).There were no statistical differences in IPSS and QOL score between the two groups at 3,6,and 12 months after operation(P>0.05).The Qmax in group B was higher than that in group A at 3 and 6 months after operation(P<0.05),but there was no statistical difference in Qmax between the two groups at 12 months after operation(P>0.05).Compared with preoperation,the IIEF-5 scores of group A were decreased at 3,6 and 12 months after operation(P<0.05),which were not in group B(P>0.05).The IIEF-5 scores at 3,6 and 12 months after operation were lower in group A than those in group B(P<0.05).There were no significant differences in the incidence of retrograde ejaculation and semen volume reduction between the two groups at 3,6 and 12 months after operation(P>0.05).Conclusion PVP has a significant impact on erectile function in the BPH patients with large volume prostate,but has no significant impact on erectile function in the patients with small volume prostate PVP surgical procedure has a certain impact on the patient's ejaculation f

关 键 词：良性前列腺增生 经尿道前列腺绿激光汽化术 勃起功能 射精功能 

分 类 号：R691[医药卫生—泌尿科学]