PPH和MMH治疗重度混合痔对性功能影响的临床观察

Clinical observation on the postoperative impact of PPH and MMH on sexual function in the treatment of severe mixed hemorrhoids

目的探讨吻合器痔上粘膜环形切除术和外切内扎术治疗重度混合痔对患者性功能的影响。方法收集2022年10月至2023年6月于梅州市人民医院行重度混合痔手术的患者资料81例,包括PPH组41例行吻合器痔上粘膜环形切除术,MMH组40例行外切内扎术,采用国际勃起功能指数量表(IIEF-5评分:≥22分为无障碍)评价男性性功能,采用女性性功能指数量表(FSFI评分:>26.55分为无障碍)评价女性性功能。所有入组患者中,有62例完成术前术后性功能评价量问卷调查表。根据量表评估两种临床最常用的手方式对患者性功能的影响。结果两组患者基线资料对比无统计学差异。PPH组术前男性性功能评分为22.0(3.5)分,术后22.0(5.0)分,P>0.05;女性术前为21.4(8.1)分,术后为23.6(6.8)分,P>0.05。MMH组术前男性性功能评分为22.5(4.0)分,术后23.0(5.0)分,P>0.05;女性术前为24.6±7.5分,术后为22.4±8.0分,P>0.05。两组男性患者手术前后IIEF-5评分中位数均≥22分,两组女性患者手术前后FSFI评分量表6个维度评分均无统计学差异。结论PPH和MMH治疗重度混合痔后患者性功能均无明显变化,手术对性功能影响方面是安全的。

Objective To investigate the impact of Procedure for Prolapse and Hemorrhoids(PPH)and Milligan-Morgan hemorrhoidectomy(MMH)on sexual function in patients with severe mixed hemorrhoids.Methods The data from 81 patients who underwent surgery for severe mixed hemorrhoids in our hospital from October 2022 to June 2023 were collected.The PPH group consisted of 41 patients who underwent PPH,while the MMH group consisted of 40 patients who underwent MMH.The International Index of Erectile Function(IIEF-5;score:≥22 indicates no impairment)was used to evaluate male sexual function,and the Female Sexual Function Index(FSFI;score:>26.55 indicates no impairment)was used to evaluate female sexual function.A total of 62 patients completed the sexual function assessment questionnaires before and after surgery.The impact of the two most commonly used surgical methods on patients'sexual function was assessed based on the scales.Results There was no statistically significant difference in the baseline data between the two groups.In the PPH group,the preoperative male sexual function score was 22.0(3.5),and the postoperative score was 22.0(5.0),P>0.05;the preoperative female score was 21.4(8.1),and the postoperative score was 23.6(6.8),P>0.05.In the MMH group,the preoperative male sexual function score was 22.5(4.0),and the postoperative score was 23.0(5.0),P>0.05;the preoperative female score was 24.6±7.5,and the postoperative score was 22.4±8.0,P>0.05.The median IIEF-5 scores of male patients before and after surgery in both groups were≥22,and there were no statistically significant differences in the six dimensions of the FSFI scores for female patients before and after surgery.Conclusion PPH and MMH treatments for severe mixed hemorrhoids do not result in significant changes in patients'sexual function,indicating that the surgeries are safe in terms of their impact on sexual function.