中国人耻骨上前列腺摘除术与经尿道前列腺电切术对勃起功能及逆行射精影响的Meta分析

Incidences of Erectile Dysfunction and Retrograde Ejaculation After Suprapubic Prostatectomy and Transurethral Resection of the Prostate in Chinese Men:A Meta-analysis

目的:利用Meta分析比较中国人耻骨上前列腺摘除术(SPPC)与经尿道前列腺电切术(TURP)对勃起功能及逆行射精影响。方法:利用MEDLINE、中国期刊全文数据库检索2009年1月以前TURP与SPPC对勃起功能影响的比较的病例对照研究。根据纳入和排除标准,筛选合适文献。应用Revman4.2软件,对纳入的文献进行Meta分析,并进行发表偏倚评估和敏感性分析。结果:8篇文献纳入本项研究,累计病例SPPC组515例,TURP组462例。SPPC组与TURP组相比发生勃起功能障碍(ED)的危险性较高,但差异无统计学意义(P>0.05),其中合并OR(95%CI)值为1.34(0.97,1.85)。SPPC组逆行射精发生率较TURP组少(P<0.05),合并OR(95%CI)值为0.58(0.44,0.76)。结论:SPPC与TURP相比,术后ED发生率差异不显著,TURP后发生逆行射精的可能性高于SPPC。

Objective： To compare suprapubic prostatectomy （SPPC） with transurethral resection of the prostate （TURP） in inducing erectile dysfunction （ED） and retrograde ejaculation （RE） in Chinese men. Methods： We retrieved all the case-controlled studies on the comparison of SPPC and TURP in inducing ED and RE by searching Medline and Chinese Journal Full-text Database （CJFD） （ up to January 2009） , screened the eligible literature according to the selection and exclusion criteria, and performed meta-analyses on the included studies using the software Revman 4. 2. Results： Eight eligible reports were identified in this study, including 515 cases of SPPC and 462 cases of TURP. The SPPC group showed a little higher incidence of ED than the TURP group （ pooled OR ： 1.34 ; 95% CI, 0.97, 1.85 ）, with no statistically significant difference （ P 〉 0.05 ） , while the latter exhibited a significantly higher incidence of RE than the former （ pooled OR ： 0.58 ; 95 % CI, 0.44, 0.76, P 〈 0.05 ）. Conclusion ： There is no significant difference between the incidence of ED after SPPC and that after TURP in Chinese men, but the latter may induce a much higher rate of retrograde ejaculation than the former.