经尿道双极等离子电切术对良性前列腺增生的疗效及其对性功能影响的研究

Impact of plasmakinetic resection of prostate on sexual function in patients with benign prostatic hyperplasia

目的探讨经尿道双极等离子电切术(TKRP)治疗良性前列腺增生(BPH)的疗效及其对性功能的影响。方法选取2009年1月至2011年6月于复旦大学附属中山医院青浦分院就诊的BPH患者130例,按照手术方式不同分为TKRP组和经尿道前列腺电切术(TURP)组,两组各65例。观察两组的国际前列腺症状评分(IPSS)、生活质量评分(QOL)和最大尿流率(Qmax),手术时间,切除前列腺组织的重量,术中出血量,留置尿管时间,术后住院时间,阴茎勃起功能障碍(ED)和逆行射精(RE)发生率。结果 TKRP组的术中出血量,置管时间和术后住院时间较TURP组明显降低(P<0.01),而手术时间和切除组织两组差异无统计学意义(P>0.05)。两组术后IPSS、QOL和残余尿水平较术前明显降低,两组的Qmax术后较术前明显提高(P<0.01);两组治疗后比较,差异无统计学意义(P>0.05)。TKRP组的6个月和9个月的ED发生率低于TURP组(P<0.05),而两组的RE发生率差异无统计学意义(P>0.05)。结论 TKRP治疗BPH具有创伤小,恢复快,对性功能影响小等优点,是一种理想的微创手术。

Objective To investigate the efficacy of plasmakinetic resection of the prostate (TKRP) in patients with benign prostatic hyperplasia (BPH), and its impact on sexual function. Methods 130 patients with BPH in our hospital from January 2009 to June 2011 were equally divided into the TKRP group ,and the transurethral prostate electric resection (TURP) group. The international prostate symptom score (IPSS),quality of life (QOL) score, maximum urinary flow rate (Qmax), operative time, weight of resected prostate tissue ,blood loss, indwelling catheter time, postoperative hospital stay, the incidence of erectile dysfunction (ED) and retrograde ejaculation (RE) were observed. Results The intraoperative blood loss, catheterization time and postoperative hospital stay were decreased significantly in the TKRP group than those in TURP group (P<0.01). The surgery time and the removal of tissue were not statistically significant between the two groups (P>0.05). The levels of postoperative IPSS, QOL and residual urine were significantly decreased. The level of Qmax after surgery was increased significantly in both groups compared with the preoperative (P< 0.01). After treatment, there was no difference between the two groups (P >0.05). The incidence of ED in the TKRP group at 6th and 9th month after the treatment was lower than those in the TURP group (P<0.05), but the RE was not significant (P>0.05). Conclusion The advantage of TKRP is little trauma, quicker recovery, and little impact on sexual function.