经尿道前列腺剜除术在重度前列腺增生患者中的疗效观察及对患者性功能的影响研究

Curative effect of transurethral enucleation of prostate in patients with severe prostatic hyperplasia and its effect on the sexual function

目的观察经尿道前列腺剜除术治疗重度前列腺增生的疗效,并分析其对患者性功能的影响。方法选取2015年1月至2016年12月阆中市人民医院诊治的80例重度前列腺增生患者进行回顾性分析。按手术方法分为观察组和对照组,各40例。对照组接受经尿道前列腺电切术,观察组则为经尿道前列腺剜除术。比较两组手术、围手术期相关指标,并发症发生情况以及治疗前后的前列腺症状评分和性功能相关指标。结果观察组的手术时间和术中出血量明显少于对照组,但观察组切除增生组织重量明显比对照组重,差异均具有统计学意义(均P<0.05)。观察组的膀胱造瘘管、尿管留置和住院天数均明显少于对照组,差异均具有统计学意义(均P<0.05)。观察组的并发症发生率明显少于对照组,差异具有统计学意义(P<0.05)。两组治疗后的IPSS评分较治疗前明显降低,MFR较治疗前明显升高,差异均具有统计学意义(均P<0.05);且观察组治疗后的IPSS评分明显低于对照组,MFR明显高于对照组,差异均具有统计学意义(均P<0.05)。对照组治疗后的性欲、性高潮、勃起功能、高潮满意度和总体满意度均明显低于治疗前,差异均具有统计学意义(均P<0.05)。观察组治疗前后的性欲、性高潮、勃起功能、高潮满意度和总体满意度均无明显变化,差异无统计学意义(P>0.05),且观察组治疗后的各项指标均明显高于对照组,差异具有统计学意义(均P<0.05)。结论经尿道前列腺剜除术治疗重度前列腺增生疗效确切,与经尿道前列腺电切术相比,对机体创伤更小,患者恢复更快,对患者性功能影响较小,值得在临床上进一步推广应用。

ObjectiveTo observe the curative effect of transurethral enucleation of prostate (TUEP) on patients with severe prostatic hyperplasia and to analyze its effect on the sexual function. MethodsThe data of 80 patients with severe prostatic hyperplasia who were treated in our hospital from January 2015 to December 2016 were retrospectively analyzed. The patients were divided into control group and observation group according to surgical methods, 40 cases in each group. The control group received transurethral resection of the prostate (TURP) and the observation group received TUEP. The operation-related and perioperative indicators, the incidence of complications, as well as prostate symptoms scores and sexual function related indicators before and after treatment were compared between the two groups. ResultsThe operation time and intraoperative blood loss in the observation group was significantly shorter and less than that in the control group, and the weight of the resected hyperplasia tissue in the observation group was significantly heavier than that in the control group, with statistically significant differences (all P <0.05). The length of bladder fistula, catheter indwelling and hospitalization was significantly shorter than that in the control group, with statistically significant differences (all P<0.05). The incidence of complications in the observation group was significantly less than that in the control group, with statistically significant difference (P<0.05). The IPSS scores of the two groups after treatment was significantly lower than those before treatment and MFR was significantly higher than that before treatment, with statistically significant differences (all P<0.05). The IPSS score in the observation group after treatment was significantly lower than that in the control group, and MFR was significantly higher than that in the control group, with statistically significant differences (all P<0.05). The libido, orgasm, erectile function, climax satisfaction and overall satisfaction of the control group after treatment were significantly lower than those before treatment, with statistically significant differences (all P<0.05). However, there were no statistically significant differences in libido, orgasm, erectile function, orgasmic satisfaction and overall satisfaction between before and after treatment in the observation group (all P> 0.05). ConclusionsTUEP is of remarkable effect in the treatment of severe prostatic hyperplasia with smaller trauma, faster recovery and less impact on the sexual function compared with TURP, which is worth further popularizing in clinical practice.