经尿道等离子前列腺切除术治疗BPH术后性功能状况调查

Sexual function changes after transurethral plasmakinetic resection of the prostate

目的 探讨经尿道等离子前列腺切除术（PKRP）对性功能的影响.方法 随访资料完整的BPH患者165例,平均年龄71（55～79岁）.平均病程5.5（3～15）年.前列腺重量平均57（33～82）g,IPSS症状评分（26.4±2.6）分,生活质量评分（5.54±0.50）分,最大尿流率（7.04±4.10）ml/s,残余尿平均120（55～250）ml.其中合并尿潴留45例、膀胱结石45例、前列腺结石15例、高血压病60例、冠心病45例、严重心律失常5例.均行PKRP,分别于术前及术后6个月行阴茎勃起功能指数、射精功能以及性生活满意度问卷调查.比较手术前后IIEF-5评分、阴茎勃起功能变化、射精功能、性生活满意程度.结果 165例患者术前IIEF-5评分为（23.4±4.7）分,术后6个月时为（24.1±4.9）分,手术前后比较差异无统计学意义（t=0.914,P〉0.05）.术前射精功能正常134例（81.2%）,异常31例（18.8%）,其中逆行射精19例（11.6%）;术后6个月射精正常41例（24.8%）,异常124例（75.2%）,其中逆行射精106例（64.2%）,手术前后比较差异有统计学意义（X2=105.22,P〈0.001）.患者术前对性生活满意者128例（77.6%）,术后132例（80.0%）,手术前后比较差异无统计学意义（X2一0.290,P〉0.05）.结论 PKRP对性功能的影响主要为射精功能异常,表现为逆向射精,对阴茎勃起功能及性牛活满意度均无明显影响.

Objective To investigate the influence of transurethral plasmakinetic resection of the prostate（PKRP）on sexual function. Methods From January 2007 to December 2007.165 patients received PKRP,who had sexual active and completed the follow-up data forms before and after surgery.The average age of this cohort was 71 years（from 55 to 79 years）.The average history of disease was 5.5（3-15）years while the average prostate volume 57（33-82）g,IPSS（26.4±2.6）,quality of lire score（5.54±0.50）,the maximum flow rate（7.04±4.10）ml/s,the average residual 120（55～250）ml.45 cases were complicated with urinary retention,and bladder stones 45 cases.15 cases with prostate stones.Their sexual function was assessed by the international index of erectile function,ejaculation function and sexual satisfaction before and 6 months after surgery by questionnaires,and compared the respective scores using SPSS14.0 and χ2 test. Results All of 165 patients,the IIEF-5 improved from（23.4±4.7）point to（24.1±4.9）point 6 months after operation（P〉0.05）,there was not significant.The abnormal ejaculation rate increased from 18.8%（31/165 patients）to 75.2%（124/165 patients）（P〈0.001）after PKRP,respectively.The retrograde ejaculation rate increased from 11.6% （19/165 patients） to 64.2%（106/165 patients） after PKRP, respectively.There was a significant difference.128 patients （77.6 % ） and 132 patients （80.0 % ） were satisfied with their sexual active before and after 6 months PKRP, respectively. Conclusions The results of this study confirmed that PKRP has no negative influence on the quality of erections measured by IIEF-5.The loss of ejaculatory function has no influence on patients sexual active.