Descazeaud Aurélien, Debré Bernard, Flam Thierry A
Department of Urology, Cochin Hospital, 27 Rue du Faubourg St. Jacques, 75014 Paris, France.
J Urol. 2006 Dec;176(6 Pt 1):2594-8; discussion 2598. doi: 10.1016/j.juro.2006.07.145.
We evaluated the influence of partner age on postoperative erectile function in patients who underwent bilateral nerve sparing radical prostatectomy for localized prostate cancer.
The study group was a cohort of 240 consecutive patients treated with radical prostatectomy with a minimum 1-year followup. None had received adjuvant therapy. Evaluation was done by questionnaires mailed to a third party. Potency was defined by erection sufficient for sexual intercourse with vaginal penetration. A total of 200 patients were evaluable.
The postoperative potency rate in 189 preoperatively sexually active patients was 59%. On univariate analysis patient age and the age difference between patient and partner were significantly associated with the potency rate following surgery, that is 60.8 and 6.8 years in the preserved potency group and 63.3 and 4.2 years in the impotent group (p <0.001 and p = 0.02, respectively). On multivariate analysis age difference was a predictive factor of postoperative potency independent of patient age (p = 0.008). Age difference was also an independent predictor of potency with and without aid (p = 0.037 and 0.002, respectively).
To our knowledge this is the first study to identify the influence of age difference between patient and partner on potency preservation following radical prostatectomy. Age difference was a significant predictive factor of maintaining postoperative potency independent of patient age. We suggest that partner age difference should be reported in radical prostatectomy outcomes series because it influences postoperative potency rates. It is a new prognostic factor that might help counseling patients preoperatively.
我们评估了伴侣年龄对因局限性前列腺癌接受双侧神经保留根治性前列腺切除术患者术后勃起功能的影响。
研究组为240例连续接受根治性前列腺切除术且随访至少1年的患者队列。均未接受辅助治疗。通过邮寄给第三方的问卷进行评估。勃起功能定义为勃起足以进行有阴道插入的性交。共有200例患者可进行评估。
189例术前有性活动的患者术后勃起功能恢复率为59%。单因素分析显示，患者年龄及患者与伴侣的年龄差与术后勃起功能恢复率显著相关，即勃起功能保留组患者年龄和年龄差分别为60.8岁和6.8岁，勃起功能丧失组为63.3岁和4.2岁（分别为p<0.001和p = 0.02）。多因素分析显示，年龄差是术后勃起功能的独立预测因素，与患者年龄无关（p = 0.008）。年龄差也是有无辅助情况下勃起功能的独立预测因素（分别为p = 0.037和0.002）。
据我们所知，这是第一项确定患者与伴侣年龄差对根治性前列腺切除术后勃起功能保留影响的研究。年龄差是独立于患者年龄的术后维持勃起功能的重要预测因素。我们建议在根治性前列腺切除术结果系列中报告伴侣年龄差，因为它会影响术后勃起功能恢复率。这是一个新的预后因素，可能有助于术前对患者进行咨询。
