股外侧皮神经移位术在根治性前列腺切除术后勃起功能障碍中的疗效分析  

Efficacy of lateral femoral cutaneous nerve transposition in erectile dysfunction after radical prostatectomy

作　　者：王江宜 顾欣[1] 刘冲[1] 于国鹏[1] 谢敏凯 徐斌[1] WANG Jiangyi;GU Xin;LIU Chong;YU Guopeng;XIE Minkai;XU Bin(Department of Urology,the Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,200125,China)

机构地区：[1]上海交通大学医学院附属第九人民医院泌尿外科,上海200125

出　　处：《临床泌尿外科杂志》2025年第3期259-262,共4页Journal of Clinical Urology

摘　　要：目的:探索股外侧皮神经移位术治疗根治性前列腺切除术后勃起功能障碍(erectile dysfunction,ED)的有效性和安全性。方法:回顾性收集2021年1月—2022年12月于上海交通大学医学院附属第九人民医院行神经移位术患者的临床资料,经纳入及排除标准筛选后共10例患者纳入分析,评估手术有效率及不良反应。结果:中位随访时间22个月,根治性前列腺切除术与神经移位术的平均间隔时间为(12.7±5.6)个月,平均手术时间(119±22) min,平均出血量为(15.0±6.7) mL。6例患者在术后12个月随访时恢复了勃起功能[国际勃起功能指数5(international index of erectile function-5,IIEF-5)评分>17分],其中接受保神经前列腺根治术的患者有效率明显高于接受非保神经前列腺根治术的患者(80%vs 40%)。术后并发症包括大腿前外侧的感觉异常,以及1例下肢肌间静脉血栓形成,未见严重并发症。结论:股外侧皮神经移位术具有较高的有效率且不良反应可控,是治疗根治性前列腺切除术后ED的可选方案。Objective:To explore the effectiveness and safety of lateral femoral cutaneous nerve transposition for treating erectile dysfunction after radical prostatectomy.Methods:A retrospective analysis was conducted on clinical data from patients who underwent nerve transposition at our hospital between January 2021 and December 2022.After screening based on inclusion and exclusion criteria,a total of 10 patients were included for analysis.The surgical effectiveness and side effects were evaluated.Results:The median follow-up time was 22 months,and the average interval between radical prostatectomy and nerve transposition was(12.7±5.6) months.The average surgical duration was(119±22) minutes,with an average blood loss of(15.0±6.7) mL.At the 12-month follow-up,6 patients regained erectile function(international index of erectile function-5[IIEF-5]>17).Among them,patients who underwent nerve-sparing radical prostatectomy showed a significantly higher effectiveness rate compared to those who underwent non-nerve-sparing radical prostatectomy(80% vs 40%).Postoperative complications included sensory abnormalities on the anterolateral thigh and one case of intermuscular vein thrombosis in the lower limbs.No severe complications were observed.Conclusion:Lateral femoral cutaneous nerve transposition demonstrates a high effectiveness rate with manageable side effects,making it a viable option for treating erectile dysfunction after radical prostatectomy.

关 键 词：勃起功能障碍 神经移位术 股外侧皮神经 根治性前列腺切除术 疗效 

分 类 号：R697[医药卫生—泌尿科学]