肾移植术后的性功能障碍治疗:阴茎假体植入手术的有效性与安全性  

Treatment of sexual dysfunction after kidney transplant:the efficacy and safety of penile prosthesis implantation

作　　者：陈千喜 郑仲杰 陈延 侯小飞[1] 洪锴[1,2] 林浩成[1,2] Chen Qianxi;Zheng Zhongjie;Chen Yan;Hou Xiaofei;Hong Kai;Lin Haocheng(Department of Urology,Peking University Third Hospital,Beijing 100083,China;Center for Reproductive Medicine,Peking University Third Hospital,Beijing 100083,China)

机构地区：[1]北京大学第三医院泌尿外科,北京100083 [2]北京大学第三医院生殖医学中心,北京100083

出　　处：《中国男科学杂志》2024年第6期122-126,共5页Chinese Journal of Andrology

基　　金：国家自然科学基金(82371633)。

摘　　要：对于男性肾移植受者(KTR),维持性功能和生育能力对生活质量至关重要,但勃起功能障碍(ED)的发病率较高。KTR患者ED的原因复杂,虽然5型磷酸二酯酶抑制剂等传统治疗对多数患者有效,但约三分之一的患者效果不佳。阴茎假体植入手术是其他治疗无效患者的最终选择。然而,肾移植后使用免疫抑制剂使得医生对PP植入手术的安全性有所担忧。本文回顾了相关临床研究,评估PP植入在KTR患者中的成功率和手术考虑因素。结果显示,KTR患者接受PP植入的总并发症风险与普通人群相当,且感染率无显著增加,但非感染性机械并发症发生率略高。总体而言,PP植入手术是治疗KTR患者ED的安全、有效选择,但需慎重考虑手术时机、围手术期药物管理和手术技术,以减少风险。For male kidney transplant recipients(KTRs),maintaining sexual function and fertility is crucial for quality of life,but the incidence of erectile dysfunction(ED)is relatively higher.The causes of ED in KTRs are complex,and while traditional treatments like phosphodiesterase type 5 inhibitors are effective for most patients,about one-third of patients still have poor responding.Penile prosthesis implantation is the final option for patients who do not benefit from other treatments.However,the use of immunosuppressants after kidney transplantation(KT)has raised concerns among doctors regarding the safety of PP implantation.This study reviewed relevant clinical researches to evaluate the success rate of PP implantation in KTRs and the surgical considerations involved.The results showed that compared to that for non-KTR patients,the complication risk for KTR patients undergoing PP implantation surgery was not significantly increased,with no significant increase in infection rates,although the incidence of non-infectious mechanical complications is slightly higher.Overall,PP implantation is a safe and effective option for treating ED in KTRs,but careful consideration of surgical timing,perioperative medication management,and surgical techniques is necessary to minimize risks.

关 键 词：肾移植 勃起功能障碍 阴茎假体植入 免疫抑制 手术并发症 

分 类 号：R699.2[医药卫生—泌尿科学] R698.1[医药卫生—外科学]