2微米铥激光前列腺切除术对性功能的影响

Impact on sexual function of 2-micron thulium laser resection of the prostate-tangerine technique

目的:探讨经尿道2微米铥激光剥橘式前列腺切除术(2-micronTmLRP-TT)治疗良性前列腺增生症对患者术后性功能的影响。方法:采用2-micronTmLRP-TT治疗BPH患者36例,记录患者最大尿流率、剩余尿量、国际前列腺症状评分、生活质量评分等指标。应用国际勃起功能指数问卷-5记录患者勃起情况并调查包括性欲、逆行性射精情况等,对手术前、后的性功能状况进行分析比较。结果:随访获得完整资料33例,随访率91.6%(33/36)。术前性功能正常的患者29例,术后患者均保留性欲和满意的性生活。术前IIEF-5评分(21.0±5.8),术后评分(19.3±6.1),两者比较差异无统计学意义。术后阴茎勃起硬度下降者占6.9%(2/29),与术前比较差异无统计学意义(P>0.05)。术后精液量明显减少者占41.4%(12/29),发生逆行性射精者占55.2%(16/29),晨间勃起次数增加者占10.3%(3/29),与术前比较差异均有统计学意义(P<0.05)。结论:2-micronTmLRP-TT治疗BPH切割精准,出血少,恢复快,并发症少,安全性高。除了精液量减少、逆行性射精外对性功能的影响较小;少数患者晨间勃起有所改善。

Objective:To evaluate the effect of thulium laser resection of the prostate-tangerine technique(TmLRP-TT)on sexual function of patients with benign prostatic hyperplasia.Methods:We treated 36 patients diagnosed of BPH with 2-micron TmLRP-TT.A 120 watts thulium laser generating continuous wave was used.The outcome was evaluated by the international prostate symptom score,quality of life score,urinary flow rates and post-void residual assessment.The sexual functions were evaluated before 2-micron TmLRP-TT and 3 months afterwards with the international erectile dysfunctions questionnaires(IIEF-5).The results of the sexual function before and after operation were compared.Results:A total of 33 patients completed the follow-up and 29 cases were included the study. No patients had newly developed impotence.No significant compared with the preoperative score(P>0.05).A slight decrease in the mean IIEF score was reported in postoperative assessments.Improvement in early morning erections after TmLRP-TT was significant(P<0.05).The ejaculatory volumes were evidently reduced postoperatively.According to general assessment question analysis,the prevalence of subjectively reported postoperative retrograde ejaculation was significantly higher than the baseline assessment(P<0.05).Conclusions:2-micron TmLRP-TT does not affect the sexual function of patients with BPH,with the exception of ejaeulum reduce and retrograde ejaculation.It did improve the ability of morning erection.