前列腺增生症患者性功能及其影响因素的关系

Evaluation of sexual function in men with symptomatic benign prostatic hyperplasia

目的探讨老年男性在前列腺增生症中性功能障碍的发病率,并分析性功能障碍与前列腺增生症病史、IPSS、前列腺体积、最大尿流率及年龄的相关性。方法对143例前列腺增生症患者进行国际前列腺症状评分(IPSS)、勃起功能国际评分(IIEF-5)、性欲与射精功能评价。并测定最大尿流率及前列腺总体积。应用秩相关分析和多元逐步回归分析方法评价各检测变量间的相关性。结果本组143例有勃起功能障碍(ED)患者116例(81.12%),性欲低下71例(49.65%),射精功能障碍45例(31.47%)。IIEF-5与性欲评分(γs=0.926,P=0.000)、射精功能评分(γs=0.836,P=0.000)具有明显一致的相关性(P<0.001)。年龄与IIEF-5(γs=-0.262,P=0.002)、性欲评分(γs=-0.268,P=0.001)、射精功能评分(γs=-0.271,P=0.001)均呈负相关性。IIEF-5及性欲、射精功能评分与BPH病史、IPSS、最大尿流率、总前列腺体积之间无明显相关性(P>0.05)。结论本研究表明:年龄是BPH患者性功能障碍的主要危险因素。虽然性功能障碍在BPH时发生率高,但BPH病史、IPSS、最大尿流率、总前列腺体积对BPH患者性功能影响不大。

Objective To evaluate the prevalence of sexual dysfunction in population of men with benign prostate hyperplasia （BPH） accompanied by lower urinary tract symptoms （LUTS）, and to assess the correlation between sexual dysfunction and urinary symptoms and age. Methods A total of 143 men with symptomatic BPH were investigated using the International Prostate Symptom Score （IPSS）, International Index of Erectile Function-5 （IIEF-5）, libido and ejaculatory function score, and the measurement of urinary flow rate and the total prostate volume. The correlation and regression analysis were used to determine the correlation among the variables. Results The mean age of the patients was （66.60±5.03） years, the mean course of BPH was （6.31±4.84） years, the mean IPSS score was （20.18±4.50）, the mean IIEF-5 score was （12.73±8.68）, the mean libido score was （2.24±0.94）, and the mean ejaculatory function score was （2.17±0.88）. There were 116 cases of erectile dysfunction （81.12%）, 71 cases of poor sexual drive（49.65% ） and 45 cases poor ejaculation （31.47% ） There was statistically significant correlation between age and IIEF-5 scores （ γs = - 0.259, P = 0.002）, libido scores （ γs = -0.258, P = 0.002）, and ejaculatory function scores （ γ = - 0.265, P = 0.001）. IIEF-5 scores, libido scores and ejaculatory function scores didnot correlate to course of BPH, IPSS, peak urinary flow rate and the total prostate volume, （P〉0.05）. Conclusion Age is the main risk factors of sexual function. Although the high ratio of sexual dysfunction in an population of men with benign prostate hyperplasia （BPH） accompanied by lower urinary tract symptoms （LUTS）, BPH and LUTS-associated factors are not very important determinants of sexual dysfunction.