Meng Fanwei, Gao Baohua, Fu Qiang, Chen Jun, Liu Yuqiang, Shi Benkang, Xu Zhishun
Department of Urology, Qilu Hospital, Shandong University, Jinan, China.
J Androl. 2007 Mar-Apr;28(2):259-61. doi: 10.2164/jandrol.106.000372. Epub 2006 Oct 4.
The aim of this study is to evaluate the effect of Ho:YAG laser enucleation of the prostate (HOLEP) to the sexual function of patients with benign prostatic hyperplasia (BPH). In the course of the study, 108 patients with BPH were recruited and accepted treatment with HOLEP. The effectiveness of treatment was evaluated by flow rate and the International Prostate Symptom Score (IPSS) before HOLEP and 6 months afterwards. Meanwhile, the sexual functions were evaluated with the Danish Prostate Symptom Score Sexual Function Questionnaire (DanPSS Sex). Before and 6 months after HOLEP treatment, the mean residual urine volume was reduced from 106.0 +/- 51.7 mL to 5.6 +/- 1.7 mL (P<.01), maximum flow rate was improved from 7.2 +/- 3.9 mL/s to 21.7 +/- 1.3 mL/s (P<.01), nocturia frequency was reduced from 5.5 to 1.5 (P<.01), and the mean IPSS score was decreased from 19.4 +/- 5.6 to 7.4 +/- 2.6 (P<.01). The proportion of patients satisfied with their libido was 55% before HOLEP and 57% 6 months afterwards, while 23.5% of the patients had no libido before and after HOLEP; 37% of the patients were satisfied with their erection before HOLEP and 40% after 6 months; 30% of the patients had completely satisfactory sex life before HOLEP, and 32% did 6 months later. The corresponding percentages of fully impotent patients increased from 33% before the procedure to 35% 6 months postoperation. Early morning erections were reported by 45% of the patients before the procedure and by 62% 6 months later (P<.01). In 70% of the patients with normal sex life, ejaculation was retrograde 6 months after HOLEP (P<.01). HOLEP does not affect the sexual function of patients with BPH but does did improve the ability of early morning erection, while causing retrograde ejaculation.
本研究的目的是评估钬激光前列腺剜除术（HOLEP）对良性前列腺增生（BPH）患者性功能的影响。在研究过程中，招募了108例BPH患者并接受HOLEP治疗。通过HOLEP术前及术后6个月的尿流率和国际前列腺症状评分（IPSS）评估治疗效果。同时，用丹麦前列腺症状评分性功能问卷（DanPSS Sex）评估性功能。HOLEP治疗前及治疗后6个月，平均残余尿量从106.0±51.7 mL降至5.6±1.7 mL（P<0.01），最大尿流率从7.2±3.9 mL/s提高到21.7±1.3 mL/s（P<0.01），夜尿次数从5.5次减少到1.5次（P<0.01），平均IPSS评分从19.4±5.6降至7.4±2.6（P<0.01）。HOLEP术前对性欲满意的患者比例为55%，术后6个月为57%，而23.5%的患者HOLEP术前及术后均无性欲；HOLEP术前37%的患者对勃起满意，6个月后为40%；HOLEP术前30%的患者性生活完全满意, 6个月后为32%。完全阳痿患者的相应比例从术前的33%增加到术后6个月的35%。45%的患者术前有晨勃，6个月后为62%（P<0.01）。在70%性生活正常的患者中，HOLEP术后6个月出现逆行射精（P<0.01）。HOLEP不影响BPH患者的性功能，但确实改善了晨勃能力，并导致逆行射精。
