剥离式经尿道前列腺电切术对前列腺增生症患者性功能影响的临床研究

Impact of peel- transurethral resection on sexual function of patients with benign prostatic hyperplasia

目的:分析剥离式经尿道前列腺电切术对前列腺增生症患者性功能影响,以期对前列腺增生的诊疗提供借鉴。方法:选取在2012年4月至2014年6月入住我院的前列腺增生症患者为研究对象,将患者随机分为两组,观察组36例和对照组30例,分别予以剥离式经尿道前列腺电切术组、经尿道前列腺电切术。比较指标:患者一般情况,手术时间,切除组织重量,术中出血量,术后膀胱冲洗时间,术后拔尿管时间,术后住院天数,术后3个月IPSS、Q_(max)、RU,术前术后12个月的HEF-15评分,并发症等疗效指标。结果:两组患者年龄、前列腺质量、IPSS评分、QOL评分、Q_(max)、RU、HEF-15(相互满意度、勃起功能、性欲、总体满意度、性高潮满意度)等性功能评分无差异(P>0.05),具有可比性。围手术期情况比较:手术时间比较,P>0.05,差异无显著意义;而术中出血、切除组织重量、膀胱冲洗时间、拔除导尿管时间、术后住院时间等的比较,P<0.05,差异有显著意义。术后随访情况比较:Q_(max)、RU、IPSS评分、QOL评分等情况的比较,P>0.05,差异无显著意义;而再次出血情况等的比较,P<0.05,差异有显著意义。两组前列腺增生症患者性功能比较:术后12个月HEF-15总分及相互满意度、勃起功能、性欲、总体满意度、性高潮满意度评分与术前比较,P<0.05,差异有显著意义。术后两组前列腺增生症患者性功能组间比较,P>0.05,差异无显著意义。结论:剥离式经尿道前列腺电切术出血更少,住院时间短,相应降低手术风险,不影响前列腺增生症患者术后性功能的恢复,并发症无明显增多。

Objectives： To analyze the impact of peel- transurethral resection on sexual function of patients with benign prostatic hyperplasia in order to provide reference for the treatment of benign prostatic hyperplasia.Methods： Patients with benign prostatic hyperplasia in our hospital from April 2012 to June 2014 were selected and randomly divided into two groups,observation group（ 36 cases） and control group（ 30 cases）. The two groups were received stripped style transurethral respectively resection and peel- transurethral resection,respectively. Compare indicators were preoperative patient general,operative time,removal of tissue weight,blood loss,postoperative bladder irrigation time,postoperative pulling catheter time,postoperative hospital stay,postoperative 3 months IPSS,Qmax,RU,preoperative and postoperative 12 months HEF- 15 score,complications outcome measures.Results： The age,prostate quality,IPSS score,QOL score,Qmax,RU,HEF- 15（ mutual satisfaction,erectile function,sexual desire,overall satisfaction,orgasm satisfaction） and other sexual function scores of the two groups had no difference（ P〉0. 05）,which were comparable. There was no significant difference in operation time,P〉0. 05. There were significant differences in bleeding,weight of resected tissue,bladder irrigation time,removal of the catheter time,postoperative hospital stay,etc.,P〈0. 05. For postoperative follow- up,there was no significant difference in Qmax,RU,IPSS score,QOL score,etc. P〉0. 05. But the difference in rebleeding was significant,P〈0. 05. For the sexual function in patients with benign prostatic hyperplasia,12 months after the operation,there were significant differences in HEF- 15 and mutual satisfaction,erectile function,sexual desire,overall satisfaction,orgasm,satisfaction scores and preoperative score,compared with the data before the operation,P〈0. 05.Sexual function between the two groups after the operation had no significant difference,P〉0. 05. Conclusions：The peel- transurethral resection causes less bleeding,shorter hospital stay and lower risk of surgery,which does not affect the sexual function recovery of patients with benign prostatic hyperplasia after surgery and has no significant increase in complications.