保存膀胱颈完整性在经尿道前列腺等离子电切术中对低龄患者勃起功能的影响

Impact of preserving the integrity of bladder neck in trans urethral resection of the prostate plasma treatment on the erectile function of young patients

目的:探究保存膀胱颈完整性在经尿道前列腺等离子电切术中对低龄患者勃起功能的影响。方法:选取2012年1月至2014年1月期间榆林市第一医院接受治疗的76例前列腺增生症患者,采用随机数表法将76例患者分为观察组和对照组,各38例。给予两组患者经尿道前列腺等离子电切术治疗,但是观察组患者在手术过程中保存膀胱颈完整性。对比两组患者术前、术后国际前列腺症状评分(IPSS)、最大尿流率(Qmax)、生活质量评估(QOL)的变化情况,逆行射精发生率和术后勃起功能障碍发生率。结果:两组患者的Qmax评分和QOL评分较术前均显著升高,IPSS较术前显著降低,且观察组患者的变化幅度显著高于对照组患者,比较两组间差异具有统计学意义(P<0.05)。术后3个月观察组患者逆行性射精发生率为55.3%(21/38),对照组患者逆行性射精发生率为28.9%(11/38),比较两组间差异具有统计学意义(P<0.05)。观察组患者术后3个月的勃起功能障碍发生率为44.7%(17/38),对照组患者术后3个月的勃起功能障碍发生率为47.3%(18/38),比较两组间差异具有统计学意义(P<0.05)。结论:给予前列腺增生症患者经尿道前列腺等离子电切术时保持膀胱颈的完整性能够有效保护患者术后勃起功能,可以在临床上进一步推广和使用。

Objectives：To explore the impact of preserving the integrity of bladder neck in trans urethral resection of the prostate plasma treatment on the erectile function of young patients.Methods：The 76 patients with benign homeostatichyperglycemia treated in Yulin First Hospital from January 2012 to January 2014 were selected and divided into observation group and control group randomly,38 patients in each.Both the two groups were given trans urethral resection of the prostate plasma treatment,but the integrity of the bladder neck was saved in the obser-vation group.The changes in International Prostate Symptom Score （IPSS）,maximum flow rate （Qmax）and Quali-ty of Life （QOL）in the two groups before and after the surgery were compared as well as the incidence of retrograde ejaculation and postoperative erectile dysfunction.Results：The Qmax score and QOL score were significantly im-proved after surgery in both groups,while the IPSS significantly reduced.Changes in the observation group were more significant than the control group,with statistically significant difference （P 〈0.05）.The incidence rates of retrograde ejaculation in the observation group and control group were 55.3% （21 /38）and 28.9% （11 /38）re-spectively,with statistically significant difference （P 〈0.05）.The incidence of erectile dysfunction three months after the surgery in the observation group and control group were 44.7% （17 /38）and 47.3% （18 /38）respective-ly,with statistically significant difference （P 〈0.05）.Conclusions：Preserving the integrity of bladder neck in trans urethral resection of the prostate plasma treatment of young patients is conducive for protecting their erectile function,which is worth further promotion in clinical practice.