Nordström G M, Nyman C R
Department of Urology, Södersjukhuset, Stockholm, Sweden.
Br J Urol. 1992 Jul;70(1):33-9. doi: 10.1111/j.1464-410x.1992.tb15660.x.
A group of 66 patients (40 males, 26 females) underwent an ileal conduit urinary diversion because of bladder cancer (44 patients) or incontinence/bladder dysfunction (22). They were questioned about pre- and post-operative sexual function and activity and it was found that 90% of the males (26/29) who were sexually active before surgery lost the ability to achieve erection following radical cystectomy. Although they were unable to achieve penile erection, 41% were able to experience orgasm by means of masturbation. Five of the 29 males received penile implants. Five of the 6 females treated by cystectomy, who were sexually active before the operation, reported either a decrease or cessation of sexual activity (i.e. coitus) post-operatively. The main problems were a decrease in sexual desire, dyspareunia and vaginal dryness. One women reported the inability to experience orgasm after surgery. Compared with women with bladder cancer, those with incontinence/bladder dysfunction were more likely to have an active sexual life after urostomy surgery. Seven females in this group, of whom 4 were sexually inactive before surgery, increased their sexual activity after the operation. For these women the conduit operation removed the need to use incontinence pads or indwelling catheters.
一组66例患者（40例男性，26例女性）因膀胱癌（44例患者）或尿失禁/膀胱功能障碍（22例）接受了回肠膀胱术式的尿流改道手术。对他们术前和术后的性功能及性活动情况进行了询问，结果发现，术前有性活动的男性患者中，90%（26/29）在根治性膀胱切除术后失去了勃起能力。尽管他们无法实现阴茎勃起，但41%的患者能够通过自慰达到性高潮。29例男性患者中有5例接受了阴茎植入。6例接受膀胱切除术的女性患者中，术前有性活动的5例术后报告性活动（即性交）减少或停止。主要问题是性欲减退、性交困难和阴道干燥。1例女性报告术后无法达到性高潮。与患有膀胱癌的女性相比，患有尿失禁/膀胱功能障碍的女性在尿路造口术后更有可能拥有活跃的性生活。该组中有7名女性，其中4名术前无性活动，术后性活动增加。对这些女性而言，导管手术消除了使用尿失禁垫或留置导尿管的需要。
