良性前列腺增生术后逆行射精的机制及预防措施的研究进展

Research progress on mechanism and preventive measures of retrograde ejaculation after benign prostatic hyperplasia surgery

良性前列腺增生是中老年男性的常见疾病,一线治疗方式为药物治疗,但随着疾病的进展或药物副作用,外科治疗将成为更佳选择。然而,不论是作为“金标准”术式的经尿道前列腺电切术或是基于各类激光平台或等离子技术的前列腺剜除术,术后随访中均发现逆行射精发生率较高。过去通常将逆行射精视为良性前列腺增生手术的代价,但近年来随着手术方式的不断改良和新技术的涌现,逆行射精问题已经引起临床医生的关注。本文主要对前列腺增生术后逆行射精的发生机制及其预防措施进行综述。这些措施主要包括各类改良术式,以及前列腺栓塞术、前列腺段尿道悬吊术等新颖的微创技术。

Benign prostatic hyperplasia(BPH)is a common disease in middle-aged and elderly men.It's first-line therapy is drugs.But with the progression of the disease or side effects of drugs,surgical treatment will become a better choice.However,either transurethral resection of the prostate,the standard procedure,or enucleation or resection of the prostate based on various laser platforms or plasma technologies cause a high incidence of retrograde ejaculation in their postoperative follow-up.In the past,retrograde ejaculation was usually regarded as the cost of benign prostatic hyperplasia surgery.In recent years,with the continuous improvement of surgical skills and the emergence of new techniques,retrograde ejaculation has aroused the attention of clinicians.This article mainly introduces the mechanism of retrograde ejaculation after benign prostatic hyperplasia surgery and the methods to reduce the incidence of retrograde ejaculation after surgery.These methods mainly include various modified surgery,as well as novel minimally invasive techniques such as prostate embolization and prostatic urethral lift.