阴茎起勃器植入手术治疗重度勃起功能障碍的效果和患者满意度

Clinical efficacy and patient satisfaction with penile prosthesis implantation for the treatment of severe erectile dysfunction

目的:观察阴茎起勃器植入术(penile prosthesis implantation,PPI)治疗中国重度勃起功能障碍(severeerectile dysfunction,SED)患者的远期效果及患者和其配偶满意度。方法:自2000年7月至2010年6月,168例SED患者按照手术规范实施PPI治疗,术后随访6个月及6个月以上的患者146名(86.9%),其中植入三件套可膨胀性阴茎起勃器(AMS700CXM)110例(75.3%),植入单件套可屈性阴茎起勃器(AMS650)36例(24.7%)。随访时间6～119个月(平均82.1个月)。利用国际勃起功能评分表(international index of erectile function5,IIEF5)及生活质量评分表(quality of life,QOL)评估PPI术后效果,利用视觉模拟量表(visual analogue scale,VAS)评估患者和配偶满意度,并进行统计学分析。结果:SED患者146例,平均年龄(35.9±12.1)岁(20～75岁);PPI术后4～6周开始性生活,未见发生感染和糜烂等严重并发症。IIEF5和QOL评分分别为21.3±1.6和1.5±0.5,比较术前(6.3±1.7和5.1±0.9)两者均得到改善(P<0.01),植入AMS650和AMS700CXM两组之间差异无统计学意义(P>0.05)。PPI术后阴茎起勃器无故障者和每月两次以上性生活者分别为98.6%和87.9%。患者及其配偶对PPI的总体满意度分别达92.5%和90.4%,其中植入AMS700CXM患者满意度优于植入AMS650患者满意度(P<0.05)。结论:PPI治疗中国SED患者可显著改善其勃起功能和生活质量,其并发症发生率也较低,植入AMS700CXM患者满意度优于植入AMS650患者。

Objective：To investigate the clinical efficacy and patient and partner＇s satisfaction with penile prosthesis implantation（PPI） for treating Chinese patients with severe erectile dysfunction（SED）.Methods：One hundred and sixty-eight SED patients were successfully treated by PPI from July 2000 to June 2010.Of the 146（86.9%） patients who had been followed up over 6 months post-operation,36（24.7%） had been implanted with one piece malleable prosthesis（AMS650） and 110（75.3%） with three piece inflatable prosthesis（AMS700CXM）.All the patients had been followed up by using international index of erectile dysfunction（IIEF5）,Quality of Life Score（QOL） for evaluating clinical efficacy and using Visual Analogue Scale（VAS） for evaluating patient and partner＇s satisfaction and the duration of the follow-up was 6 to 119 months.Results：The mean age of patients was 35.9±12.1 years（20 to 75 years）,All the operations were successful and sexual intercourse with PPI was performed post 4 to 6 weeks without severe complications like infection and erosion.The prosthesis survive rate and frequent sexual intercourse rate were 98.6% and 87.7% respectively.IIEF5 scores pre and post PPI were 6.3±1.7 and 21.3±1.6 respectively,the QOL scores pre and post PPI were 5.1±0.9 and 1.5±0.5 respectively,and both of them showed significant improvement（P〈0.01）.As for VAS,the patient and partner＇s overall satisfaction rates were 92.5% and 90.4% respectively.Moreover,better satisfaction was showed with AMS700CXM as compared with AMS650（P〈0.05） in patients with SED.Conclusion：PPI is the safe and effective treatment option for Chinese patients with SED.The AMS700CXM penile prosthesis is better than AMS650 for patients＇ overall satisfaction.