不同剂量非那雄胺对经尿道前列腺汽化电切术患者尿道功能与性功能的影响

The effects of different doses of finasteride on urethral function and sexual function of patients undergoing transurethral vaporization of prostate

目的探讨不同剂量非那雄胺对经尿道前列腺汽化电切术(TUVP)患者尿道功能及性功能的影响。方法我院收治的102例良性前列腺增生患者,采用随机数字表法分为对照组、低剂量组与高剂量组各34例。低剂量组、高剂量组在行TUVP术前2周分别给予5 mg、10 mg非那雄胺治疗,对照组不给予非那雄胺治疗。比较各组围手术期指标、前列腺组织微血管密度(MVD)及血管内皮生长因子(VEGF)表达量及国际前列腺症状评分(IPSS),测定手术前后最大尿流量(Qmax)、残余尿量(RU)等尿道功能指标及国际勃起功能指数-5(IIEF-5)等性功能指标。结果高剂量组与低剂量组术中出血量、MVD、VEGF阳性表达数低于对照组(P<0.05),高、低剂量组间各指标比较差异无统计学意义(P>0.05);术后1个月时高剂量组与低剂量组IPSS评分及Q_(max)、RU等尿道功能指标低于对照组(P<0.05);各组术后IIEF-5评分及阴茎勃起功能障碍发生率、逆行射精发生率比较,差异无统计学意义(P>0.05)。结论TUVP术前使用非那雄胺可降低术中出血,改善早期临床症状、尿道功能,5 mg及10 mg非那雄胺对改善TUVP手术出血量及尿道功能方面相当。

Objective To explore theeffects of different doses of finasteride on urethral function and sexual function of patients undergoing transurethral vaporization of prostate(TUVP).Methods One hundred and two patients with benign prostatic hyperplasia(BPH)admitted to our hospital were enrolled.The patients were divided into a control group,a low-dose group and a high-dose group by using random number table method,34 in each group.At 2 weeks before TUVP,the low-dose group and the high-dose group were given 5 mg and 10 mg finasteride,while the control group was given no finesteride.The perioperative indexes,micro-vessel density(MVD),vascular endothelial growth factor(VEGF)expression in prostate tissue and international prostate symptom score(IPSS)were compared among the three groups.The urethral function indexes such as maximum urine flow(Qmax),and residual urine(RU)volume and sexual function indexessuch as international index of erectile function-5(IIEF-5)before and after surgery were detected.Results The intraoperative blood loss,MVD,and positive expression of VEGF in the high-dose group and the low-dose group were significantly less than those in the control group(P<0.05).There was no significant difference between the high-dose group and thelowdose group in above indexes(P>0.05).After 1 month of operation,IPSS score,urethral function indexes such as Qmaxand RU in the high-dose group and the low-dose group were significantly lower than those in the control group(P<0.05).There was no significant difference in postoperative IIEF-5 score,incidence of penile erectile dysfunction or retrograde ejaculation among the three groups(P>0.05).Conclusion The application of finasteride before TUVP can reduce intraoperative bleeding,improve the early clinical symptoms and urethral function.The improvement effect of 5 mg and 10 mg finasteride are equivalent on bleeding volume of TUVP and urethral function.