低功率融合波铥激光前列腺剜切术对良性前列腺增生患者性功能的影响

Effect of transurethral thuliumlaser vapoenucleation of the prostate with low-power conventional pulse mode on sexual function in patients with benign prostatic hyperplasia

目的:探讨应用新型低功率融合波铥激光行经尿道前列腺剜切术对良性前列腺增生(BPH)患者性功能的影响。方法:选取2022年1月至2023年6月江苏大学附属金坛医院泌尿外科收治的BPH患者89例,随机分为低功率融合波铥激光行经尿道前列腺剜切(LP-ThuVEP)组45例和经尿道前列腺等离子切除(TUPKRP)组44例,记录围手术期指标,对比分析两组患者术前和术后3、6个月IPSS、Qmax、Qavg、PVR、QoL,通过国际勃起功能指数评分问卷表5(IIEF-5)和男性性健康调查问卷-射精功能障碍评分(MSHQ-EjD)评价手术对男性性功能的影响。结果:与TUPKRP组比较,LP-ThuVEP组在手术时间上差异无统计学意义(P>0.05),在膀胱冲洗时间、留置尿管时间、手术日血红蛋白下降幅度、术后排便诱发肉眼血尿消失时间方面,有显著差异(P<0.05或P<0.01)。两组围手术期并发症相当。排尿状况指标中,LP-ThuVEP组术后3个月IPSS、QoL评分和PVR较TUPKRP组有统计学差异(P<0.05);在男性性功能方面,IIEF-5评分在术后3个月及术后6个月两组间比较均有统计学差异(P<0.05);除了术后3个月组间射精相关满意度评分无统计学差异(P>0.05)之外,其他的组间及组内的术后3个月和术后6个月射精功能及满意度评分均有显著差异(P<0.01)。结论:较之TUPKRP,LP-ThuVEP同样可以高效解除BPH导致的尿路梗阻,且具有损伤更小、患者勃起功能和射精功能恢复更快等优势。

Objective:To explore the effect of a novel transurethral thulium laser vapoenucleation of the prostate with low-power conventional pulse mode(LP-ThuVEP)on sexual function in patients with benign prostatic hyperplasia(BPH).Methods:89 BPH patients admitted to Department of Urology,Jintan People's Hospital,Affiliated to Jiangsu University,from January 2022 to June 2023 were selected and randomly divided into the LP-ThuLEP group(45 cases)and the transurethral plasma kinetic resection of the prostate(TUPKRP)group(44 cases).Perioperative indicators were recorded,and the IPSS,Qmax,Qavg,PVR,and QoL of the two groups of patients before surgery and 3 months and 6 months after surgery were comparatively analyzed.The effect of surgery on male sexual function was evaluated through the International Index of Erectile Function-5(IIEF-5)score and the Male Sexual Health Questionnaire-Ejaculatory Dysfunction(MSHQ-EjD)score.Results:Compared with the TUPKRP group,the LP-ThuVEP group had no statistically significant difference in operation time(P>0.05),but there were statistical differences in bladder irrigation time and indwelling urinary catheter time(P<0.05)and significant statistical differences in the decrease in hemoglobin on the day of surgery and the disappearance time of gross hematuria induced by defecation after surgery(P<0.001).The perioperative complications of the two groups were comparable.Among the urinary tract symptom indicators,the LP-ThuVEP group had statistically significant differences in IPSS score,QoL score,and PVR compared with the TUPKRP group 3 months after surgery(P<0.05).In terms of male sexual function,there was a statistical difference in IIEF-5 scores between the two groups at 3 months and 6 months after surgery(P<0.05);Except that there was no statistical difference in the ejaculation-related satisfaction scores between the two groups at 3 months after surgery(P>0.05),there had all significant statistical differences in ejaculation function and satisfaction scores between and within the groups at 3 months and 6 months after surgery(P<0.001).Conclusion:Compared with TUPKRP,the LP-ThuVEP can also effectively relieve urinary tract obstruction caused by BPH and has the advantages of less damage and faster recovery of erectile function and ejaculatory function of patients.