180W绿激光汽化术与电切术对BPH患者性功能的影响

Impact on Sexual Functions 180W Greenlight Laser PVP vs. TURP

目的观察功率180 W绿激光前列腺汽化术对良性前列腺增生患者性功能的影响。方法选择2017年6月至2018年12月,良性前列腺增生(benign prostatic hyperplasia,BPH)患者100例,随机数字法分为观察组与对照组,每组患者各50例。观察组采用180 W绿激光经尿道前列腺汽化术,汽化功率180 W,凝固功率30 W;对照组采用经尿道等离子前列腺电切术,电切功率160 W,电凝功率80 W。记录患者术前和术后6个月的国际勃起功能问卷表-5(Interntional index of erectile function,IIEF-5)评分、射精功能评分(Chinese index of sexual function for premature ejaculation,CIPE)评分、夜间阴茎勃起强度,比较两组患者手术前、手术后性功能变化情况。结果两组患者术前IIEF-5评分、CIPE评分、勃起强度比较,差异无统计学意义(P>0.05)。术后6个月,两组患者性功能较术前均有不同程度的下降,但观察组性功能下降程度明显低于对照组,两组比较差异均具有统计学意义(P<0.05)。结论180 W绿激光前列腺汽化术较TURP对性功能的影响小,对于具有性功能的BPH患者,可作为优先选择的手术方式。

Objective To explore the effect of photoselective vaporization of prostate(PVP) with 180 W greenlight laser on sexual functions.Methods Totally 100 patients of BPH treated from Jun.2017 to Dec.2018 were selected and randomly divided into the observation group and control group,50 cases in each group.The patients in the observation group were given photoselective vaporization of prostate(PVP) with 180 W greenlight laser,(vaporization power 180 W,coagulation power 30 W),and those in the control group transurethral resection of prostate(TURP)(cut power 160 W,and coagulation power 80 W).All the patients of the two groups were assessed with interntional index of erectile function(IIEF-5),chinese index of sexual function for premature ejaculation(CIPE) and nocturnal penile tumescence test(NPT) both before the operation and 6 months after the operation,and the data recorded were analyzed.Results None of the differences of preoperative and postoperative IIEF-5 score,CIPE score,NPT between two groups In both groups,the sexual functions of the patients were poorer 6 months after the operation than before the operation,but the declination in the control group was greater than that in the observation group,indicating a difference that was statistically significant(P <0.05).Conclusions Photoselective vaporization of prostate(PVP) with 180 W greenlight laser on sexual functions has less effect on sexual function than TURP,and may be a preferred surgical method for BPH patients with normal sexual functions.