尿道狭窄重建术后性功能障碍的回顾分析

Aretrospective study of sexual dysfunction after reconstructive surgery for urethral stricture

目的:总结影响尿道狭窄重建术后性功能结局的相关因素,提高该类疾病诊治效果。方法:复习近年尿道狭窄重建术后性功能结局相关文献,分析总结结局影响因素。结果:6类因素(患者年龄、术前合并症及性功能状况、狭窄长度及严重程度、术者经验及手术修复质量、术后随访时间以及骨盆创伤强度)均可影响接受尿道重建患者术后的性功能结局,高龄且具有合并症者对术后性功能产生不利影响,尿道狭窄更长更复杂者术后勃起功能降低似乎更明显,狭窄部位对性功能的影响较为复杂,术者经验丰富及手术质量高术后并发症发生可能更低,但具体手术方式的影响复杂,损伤而非手术导致大多数远期性功能障碍,部分患者随着随访时间延长性功能可望获得改善。然而,上述各具体因素的确切权重尚不清楚,需待进一步探讨。结论:尿道重建患者术后性功能结局受多因素影响,具体因素的确切权重需进一步探讨。推荐外科手术结局报告标准化、规范化。

Objectives：To summarize the influencing factors for postoperative sexual function outcomes of urethral stricture reconstruction,to improve level of diagnosis and treatment of urethral stricture disease.Methods：Recent literatures relevant about the influencing factors for postoperative sexual function outcomes of urethral stricture reconstruction was summarized,reviewed,and analyzed.Results：Six categories of influencing factors had effects on the sexual function outcomes of urethral stricture reconstruction,including patient age,preoperative complications and preoperative sexual function,length and severity of urethral stricture,surgeon＇s experience and the quality of surgical repair,postoperative follow-up time and severity of pelvic trauma.An advanced age and comorbidity had a negative influence on postoperative sexual function.The trend of postoperative suboptimal sexually withlonger and more complex urethral stricture seemed to be more obvious.The influence of stricture sites on sexual function was complicated.The postoperative complications of an experienced surgeon and reconstructive surgery of high quality were fewer but the effects of specific operation method were more complicated.Injury rather than surgery resulted in the most long-term sexual dysfunction,and some patients＇ sexual function might recover during follow-up visit.Nevertheless,the exact weight of each factor above was unclear and needed further exploration.Conclusions：Multiple factors affect the postoperative sexual function outcomes of urethral stricture reconstruction,and the exact weight of each factor needs to be further studied.Standardized and normalized reporting of postoperative outcomes for urethral stricture reconstruction should be strengthened according to related guidelines.