良性前列腺增生术后泌尿系统感染患者性功能障碍发生情况及其影响因素分析

Analysis of sexual dysfunction condition and its influencing factors in benign prostatic hyperplasia patients with postoperative urinary infection

目的分析良性前列腺增生术后泌尿系统感染患者性功能障碍发生情况及其影响因素。方法选取2020年1月至2023年1月儋州市人民医院泌尿外科收治的475例良性前列腺增生术后泌尿系统感染患者作为研究对象。收集患者基线资料、实验室指标;采用国际勃起功能指数-5(IIEF-5)、症状自评量表(SCL-90)评估患者性功能障碍及焦虑、抑郁情况。根据IIEF-5评估标准将患者分为障碍组与正常组,采用Logistic回归分析良性前列腺增生术后泌尿系统感染患者发生性功能障碍的影响因素。结果术后3个月,475例患者中98例评估为性功能障碍(障碍组),占20.63%;两组糖尿病史占比、高血压史占比、睾酮水平、一氧化氮(NO)水平、伴焦虑占比及伴抑郁占比比较,差异具有统计学意义(P<0.05);多因素Logistic回归分析显示,糖尿病史、高血压史、睾酮及NO水平下降、伴焦虑、伴抑郁是良性前列腺增生术后泌尿系统感染患者性功能障碍的影响因素(P<0.05)。上述指标联合预测性功能障碍的曲线下面积为0.897(95%CI:0.863~0.931),具有一定的预测价值。结论良性前列腺增生术后泌尿系统感染患者部分伴有性功能障碍,糖尿病史、高血压史、睾酮及NO水平下降、负面情绪是发生性功能障碍的影响因素,临床可针对相关因素加强干预,以便降低性功能障碍的发生风险。

Objective To analyze the sexual dysfunction condition and its influencing factors in benign prostatic hyperplasia(BPH)patients with postoperative urinary infection.Methods A total of 475 BPH patients with postoperative urinary infection who visited Department of Urology,Danzhou People′s Hospital from January 2020 to January 2023 were selected as the study subjects.The baseline data and laboratory indexes of patients were collected.The international index of erectile function questionnaire-5(IIEF-5)and symptom checklist-90(SCL-90)were used to evaluate the sexual dysfunction,anxiety and depression condition of the patients.According to the IIEF-5 evaluation criteria,the patients were divided into the dysfunction group and the normal group.Logistic regression analysis was performed to analyze the influencing factors of sexual dysfunction in BPH patients with postoperative urinary infection.Results At 3 months after operation,98 of the 475 patients were evaluated as having sexual dysfunction(dysfunction group),accounting for 20.63%.There were statistically significant differences between the two groups in the proportion of diabetes history,hypertension history,testosterone,nitric oxide(NO),combined with anxiety and combined with depression(P<0.05).Multivariate Logistic regression analysis showed that the history of diabetes,hypertension,decreased levels of NO and testosterone,combined with anxiety and combined with depression were the influencing factors of sexual dysfunction in BPH patients postoperative with urinary infection(P<0.05).The area under the curve of the above indicators combined prediction for sexual dysfunction was 0.897(95%CI:0.863-0.931),which had certain predictive value.Conclusions Some of BPH patients with postoperative urinary infection are accompanied by sexual dysfunction,and the history of diabetes,hypertension,decreased testosterone and NO,and negative emotions are the influencing factors of sexual dysfunction.Clinical intervention can be strengthened for related factors to reduce the risk of sexual dysfunction.